Over at Advanced Practitioner UK, they are having the same issues as we are in regards to prescribing practice rights and dealing with patients who ask for antibiotics for colds and flus. Here's my response to the link. Enjoy!
I diagnose and treat medical conditions in my office on a daily basis. My collaborating MD often praises me for not jumping to conclusions and diagnosing something as the most the obvious. It is a learned skill that new MDs have to learn as well. Just because someone has a degree of MD behind their name does not make them a better health care provider or prescriber. I had a recent teenaged female in my office that had been treated by her regular MD as a sore throat. With no response, she came to me and after taking the time to do a complete history and physical. I figured out pretty quickly that she had Mono. Did the test to confirm right there in the office and she and Mom were so impressed that they will be seeing me for their primary care from now on. It's just that fast to lose a patient if you don't listen to them.
I diagnose and treat medical conditions in my office on a daily basis. My collaborating MD often praises me for not jumping to conclusions and diagnosing something as the most the obvious. It is a learned skill that new MDs have to learn as well. Just because someone has a degree of MD behind their name does not make them a better health care provider or prescriber. I had a recent teenaged female in my office that had been treated by her regular MD as a sore throat. With no response, she came to me and after taking the time to do a complete history and physical. I figured out pretty quickly that she had Mono. Did the test to confirm right there in the office and she and Mom were so impressed that they will be seeing me for their primary care from now on. It's just that fast to lose a patient if you don't listen to them.
An easy clue to diagnose mono is the failure to respond to an antibiotic. If health professionals worked as colleagues and not try to one up each other the correct response to that presentation would have been to support the MD that saw the patient first and say he or she would also be diagnosing mono on the second presentation. Very poor effort in my view.
ReplyDeleteAnonymous, I can take that comment in two different lights. One that I'm trying to "one up the MD", which I wasn't. I just get tired of the assumption that NPs don't diagnose and treat patients with the same types of skills as MDs do. I know that doctors don't like the idea that we can.
ReplyDeleteThe other light is that it was poor performance on the MD's end by not taking the time to get the prodomal symptoms and test for something easy in the office.
Ouch. Obviously hit a nerve. If you have the same skills as MDs you will obviously miss IM. I was trying to make the point that undermining your colleagues is not smart and getting a patient to change their treating professional on one obvious diagnosis is perhaps a bit over the top.
ReplyDeleteI did not get that patient to leave their MD. They came to my office where I am the only provider in a primary practice setting. I see patients all the time and do not "steal" them. Patients come to different offices because they are not happy with their provider be it NP or MD. I'm sure that I've missed things, as no one is perfect. Just keep thinking that we NPs should get some recognition instead of being slammed on some sites, especially if they (the ones badmouthing us) have never really worked with us before.
ReplyDelete"...I'm sure that I've missed things..."
ReplyDeleteWell, perhaps you'd like to fess-up and let us know what you and your like-minded colleagues ARE missing.
Anon(2)
very nice blog site some how i found you looking for things on our sons birth defect esophageal atresia, i wish you all the best.
ReplyDeleteYou first Anon. I'm sure that the docs down under miss things as well. I have missed things like kidney stones which I thought were UTI at first and usually due to vagueness of symptoms given by the patient. I think everyone does that. Most diagnoses are rule outs anyway. I will tell you that I have found more things than I've missed so far. Why post as Anonymous anyway?
ReplyDeleteKayla, I hope you found the information that you were looking for. Thanks for leaving a nice comment.
ReplyDelete