[NPInfo] Physician blogs maligning NP s and PAs

[AnnMarie Roetzer]

A message to everyone, never estimate the amount of power that you have... 
   
  I work for a small Cardiology group. We have the ability to do cath with intervention, but for open heart surgery we have to refer to another hospital in our system. There are two major groups of CV surgeons and we were encouraged to use both groups and "spread it out."
   
  Well we had persistant problems with lack of follow up, no updates on patients condition, and worse yet no notification that they are being discharged. We even had patients who showed up in the emergency room with the post op complications and we didnt even know that they were discharged. Needless to say, my group was not happy with this and we made this known. 
   
  Group #1 had their nurse call me and speak to me about what we could do to improve things. I mentioned the need to be kept in the loop with patients and she said "they could try to keep us in the loop" but it might be hard because its hard to know where the patients come from. Not ONE MD or NP from the surgery group called and spoke to me at all. 
   
  Group #2 had their senior surgeon call me personally, and provide me with his cell phone and pager number. He also didnt say he would "try" to keep us in the loop, he guaranteed that we would be well notified about the patients and their condition. He spoke with me on the phone for a few minutes and was very personable.
   
  After this I spoke with my doctors, and we decided to start sending patients to the second group. They have been true to their word, calling on an almost daily basis to update us about the patients that we have down there. I speak with the nursing staff, the NPs, and the surgeons too. Overall the quality has improved, and I guess they have been rewarded by a large number of open heart cases. 
   
  I was wondering exactly when group #1 would notice that they havent gotten any cases....well they finally did. They requested a meeting with ALL the cardiology providers... my two doctors (somehow they forgot about me the NP). How hysterical.... just proves why they are not getting business. 
   
  Both of my doctors are completely behind whatever I want to do. They are happy with the CV surgery group... I do alot of arranging of transfer and follow up with the surgical patients, so they feel that its my choice where I want to send the patients and who I prefer to deal with. 
   
  So the moral of the story... never underestimate the power that you have! :)

jlambertrn at comcast.net wrote:
  Karen,
I echo your thanks to Stephen and David. I agree whole heartedly with you and your thoughts and the fact that much of our knowledge/training is similar to the apprentice concept that has been working for centuries. (Sorry about the run-on sentence; my high school english teacher is probably rolling over in her grave!) As you, I too remain humbled by the amazing amount of knowledge that is out there that we (including docs) need to be on top of. I treat people with respect, and expect the same in return, docs included. For the most part, I enjoy a very collegial relationship with the other docs in the ED where I work. Occasionally, I have to call a specialist for a consult. Most are receptive to me as a NP, however you still run across the arrogant jerk every now and then. I always remember who they are when I am moonlighting in primary care as I frequently do. Does a doc really think I am ever going to refer a patient to him/her after being disrespectful or unprofession!
al towa
rds me? If the offender treats a colleague in that manner, how will he treat my patient? Nope, no referrals for you! 
As far as Panda Bear is concerned, I feel he has way too much time on his hands. His post was long, rambling and most of all B-O-R-I-N-G. One of the AMA's beefs with us has always been "they take patients away from us, and it will affect my ability to earn a living". Does Panda Bear have any clue to the difficulty a patient encounters when he/she calls their PCP on a day when they truly ill and are told that the next available appt. is in two weeks? We see these patients in the ED every day, so there goes the theory of "us" stealing "their" patients. Paaaaallleeeeeze! There are plenty of patients to go around and that is an unfounded, tired, mundane talking point put forth by the AMA and other groups. That argument impacts patients in a very negative manner. Yep, reading that blog, made me get the same feeling in my gut that I get when I have to call that arrogant ENT or surgeon, or whatever. The positive point in all of this is that I LOVE WHAT I DO, and like Peg Fitzgera!
ld alwa
ys says "Being a NP is the BEST job on the planet". So what next? We all go on doing what we always do- providing quality, evidence-based care to our patients who put their faith and trust in us every day. One patient at a time. I think it's time to join the ACC- Dave Mittman, are you listening? I have my credit card in hand. LOL.
Julie Lambert, FNP
Ocean County NJ
-------------- Original message -------------- 
From: karenfnp at comcast.net 

> Stephen and David, 
> 
> Thanks for your comments and the sample blog. As a champion, especially for 
> NPs, I like to hear what others say about us in order to facilitate 
> bridgebuilding. One aspect of health care provider training I like to stress 
> with docs and advanced practice clinician students is that so much of what we 
> learn in the medical aspect of what we do is apprentice based. We all have to 
> learn the same new info when new diagnoses, treatments and meds emerge on the 
> health care scene via CME and OJT to maintain quality evidence based practices. 
> ( To have more residency programs for PAs and NPs in speciality areas would give 
> us more credibility in specific content areas.) I like to maintain a posture 
> of humility in terms of all that we need to know these days and respect docs who 
> do the same. It looks like this "panda bear physician", per the content in this 
> blog blurb, chooses to spend energy putting NPs PAs down and reminds me how we 
> have to choose where to spend our energy in ! 
> buildin 
> g our allies in the physician community and not waste it a la "casting pearls 
> to swine" as Jesus said once. 
> 
> Karen Riesinger FNP 
> Portland, OR 
> 
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