Facilities designer: Medicare is 'the biggest Ponzi scheme of all time'
Comments
I will not allow any one else but an MD make a decision on health care Rx and management. Teeth are diffrent from health
Equating a dental hygienist with a physician...
The idea that NP and PA's can work equivalent to doctors and somehow improve quality while reducing costs, then being able to judge when physicians are performing in a "substandard" fashion.
My understanding of NP's, reading their literature, is that they have a lot more training so they can practice independently...seems like this logic of this architect (who doesn't actually practice medicine)is that NP's have more education to qualify them to practice medicine, and pass judgement on medical practice, but they don't have as much eduction as physicians, which would make them dangerous...
As a specialty physician, as long as I don't share the risk of these lesser trained folks, fine. I make a lot of money because they order a lot more expensive radiology examinations than do most physicians....a lot more lab...etc. etc.
How many doctors design hosptials? If this is the best the Healthcare Facilities Symposium could pick as a presentor, that explains a great deal. Doctors don't have the time for such nonsense lectures as they are doing VIABLE work. Leave your arm chair opinions for the coffee shop and local op-ed page. Better yet, design something real!
By reading your responses, I am uncertain if either of you know what an NP is! There is an obvious lack of understanding regarding the educational preparation of this advanced practice nurse.
NP's are Registered Nurses with Masters or Doctoraldegrees. The first program for training NPs was established in 1965, so their presence is nothing new. What is new is the recognition, based on numerous studies, that they can provide in many cases (and I qualify this by saying not all...) equal to superior patient outcomes when compared to physicians, especially in the primary care arena. There are several physicians in my family, and many of my closest friends are physicians (the result of a 25-year nursing career). I beleive that there is a place for physicians and NP's... both. I would rather see my NP as a primary care practitioner and have a physician remove my appendix- their specialization in skill is highly valued to me and my patients. Read some of the literature out there... it may inform and hopefully change your opinion somewhat.
Grumbach, L., Hart, L. G., Mertz, E., Coffman, J.,
Palazzo, L. (2003). Who is caring for
the underserved? A comparison of
primary care physician and nonphysician
clinicians in California and Washington.
Annals of Family Medicine, 1, 97-
104.





