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Kim Pegula is receiving medical care


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13 hours ago, RunTheBall said:

Make sure you see an MD or a DO for your initial evaluation, not a PA or Nurse Practitioner.

 

With the continued bureacratization of medicine and the heavy presence of private equity, the business of medicine is destroying it. Docs are being replaced with NP’s and PA’s who are “supervised” by and MD/DO. It’s getting very scary out there.

 

That’s not to say there aren’t good NPs and PAs who are great in their role, but how does someone not in the field know what they are getting? Put it this way, you can get an online Doctorate in Nurse Practitioner with 500 hours of shadowing (that’s not even practicing) and practice independently in many states while calling yourself “Doctor”. An attending physician has a minimum  21,000 hours of clinical training (not shadowing) before practicing independently. A barber has 1500 hours of cutting hair under supervision, and a Pet Smart groomer has over 800 hours of grooming under supervision before they can cut your dog’s hair. 

 

Medicine is a business, you are the consumer. Know what you are paying for.

 

 

As a general rule you may be right but blanket statements make me nervous.

 

The squadron I went to war with had both an MD and a PA.  Obviously, the training of the MD was more rigorous.  But the PA had years more experience as well as more "common sense."  When we had routine injuries and illnesses, most of the squadron's soldiers sought out the PA.    

 

If I have a routine problem nowadays, I'm more than happy to have a NP or PA evaluate me.  

 

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14 hours ago, RunTheBall said:

Make sure you see an MD or a DO for your initial evaluation, not a PA or Nurse Practitioner.

 

With the continued bureacratization of medicine and the heavy presence of private equity, the business of medicine is destroying it. Docs are being replaced with NP’s and PA’s who are “supervised” by and MD/DO. It’s getting very scary out there.

 

That’s not to say there aren’t good NPs and PAs who are great in their role, but how does someone not in the field know what they are getting? Put it this way, you can get an online Doctorate in Nurse Practitioner with 500 hours of shadowing (that’s not even practicing) and practice independently in many states while calling yourself “Doctor”. An attending physician has a minimum  21,000 hours of clinical training (not shadowing) before practicing independently. A barber has 1500 hours of cutting hair under supervision, and a Pet Smart groomer has over 800 hours of grooming under supervision before they can cut your dog’s hair. 

 

Medicine is a business, you are the consumer. Know what you are paying for.

 

 

Most "medical consumers" know exactly what they are paying for (more accurately, what their insurer or the public is paying for).  It has been routine for decades in this country for patients to see providers other than an MD/DO.  NP's have long been licensed to practice unsupervised.  PAs less so.  MDs aren't being "replaced"--there simply aren't enough of them (and a lot of them aren't very good).  

 

Your "attending physician" doesn't need close to "a minimum of 21,000 hours of clinical training before practicing independently".   A Primary Care or Family Medicine or Pediatric MD trains for 3 years and at most 80 hours a week (they don't come close to this).  The most hours they could log would be 12,000.  And still in their frist year of practice may be less useful to the patient than their seasoned NP/PA.

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2 hours ago, Mr. WEO said:

 

Most "medical consumers" know exactly what they are paying for (more accurately, what their insurer or the public is paying for).  It has been routine for decades in this country for patients to see providers other than an MD/DO.  NP's have long been licensed to practice unsupervised.  PAs less so.  MDs aren't being "replaced"--there simply aren't enough of them (and a lot of them aren't very good).  

 

Your "attending physician" doesn't need close to "a minimum of 21,000 hours of clinical training before practicing independently".   A Primary Care or Family Medicine or Pediatric MD trains for 3 years and at most 80 hours a week (they don't come close to this).  The most hours they could log would be 12,000.  And still in their frist year of practice may be less useful to the patient than their seasoned NP/PA.

 

Depends on the state if an NP can practice alone. PA's in every state must be supervised.

 

Experience wise there can be a difference with an NP and a PA. At least when they first start practicing.

 

To become an NP you have to first become an RN. Some states require an ASN (associates) and some BSN (bachelors). If you started with an ASN, you have to then complete your BSN. Then you can work on either an MSN or a Doctorate for you NP program. Currently, the minimum for NP is an MSN. However, that was supposed to change to a minimum of a doctorates, but thats been put on hold from what I understand. So your typical NP has many years of actual experience in the medical field, prior to taking the leap to become an NP. 

 

To become a PA, you only need a bachelors degree and it can be in anything. PA schools have pre-req classes, but your degree doesn't matter. There are some schools that offer a 4 year degree while simultaneously going to PA school, but not many as I found in my research. So essentially, you can have someone that got a bachelors in history, then decided to become a PA. My wife worked with a PA that did this. PA school itself is about 3 yrs. 

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3 hours ago, Mr. WEO said:

 

Most "medical consumers" know exactly what they are paying for (more accurately, what their insurer or the public is paying for).  It has been routine for decades in this country for patients to see providers other than an MD/DO.  NP's have long been licensed to practice unsupervised.  PAs less so.  MDs aren't being "replaced"--there simply aren't enough of them (and a lot of them aren't very good).  

 

Your "attending physician" doesn't need close to "a minimum of 21,000 hours of clinical training before practicing independently".   A Primary Care or Family Medicine or Pediatric MD trains for 3 years and at most 80 hours a week (they don't come close to this).  The most hours they could log would be 12,000.  And still in their frist year of practice may be less useful to the patient than their seasoned NP/PA.

 

No they don't. That isn't even a little true. As somebody who as been chasing some unidentified health issues the last 2 years this is not even close to true. I have had some specialists who spend 15 minutes with me and others who spend an hour. I have had some appointment where I schedule with the doctor and only seen their fellow or PA. I have almost no idea what my testing is going to cost and what my insurance will cover until I receive a bill in the mail. 

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35 minutes ago, Mango said:

 

No they don't. That isn't even a little true. As somebody who as been chasing some unidentified health issues the last 2 years this is not even close to true. I have had some specialists who spend 15 minutes with me and others who spend an hour. I have had some appointment where I schedule with the doctor and only seen their fellow or PA. I have almost no idea what my testing is going to cost and what my insurance will cover until I receive a bill in the mail. 

 

Only if they choose not to. 

 

The time you spend with your specialist doctor will always vary--patients with any experience in the health care system have always known this.  They also know on many visit they will see the midlevel provider for ongoing care---also not new.  I guess if you are someone with little or no contact with health care, you may be surprised that you aren't seeing a doctor.  But patients over 30 without prior contact with the the system are an extreme rarity, perhaps you are one of those?  Of course, when you make the appointment, you could simply ask who will be seeing you.

 

Similarly, as for how much testing will cost, federal law requires hospitals to post the cost of tests and procedures online.  No reason to have "no idea" what the costs will be. 

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29 minutes ago, Mr. WEO said:

 

Only if they choose not to. 

 

The time you spend with your specialist doctor will always vary--patients with any experience in the health care system have always known this.  They also know on many visit they will see the midlevel provider for ongoing care---also not new.  I guess if you are someone with little or no contact with health care, you may be surprised that you aren't seeing a doctor.  But patients over 30 without prior contact with the the system are an extreme rarity, perhaps you are one of those?  Of course, when you make the appointment, you could simply ask who will be seeing you.

 

Similarly, as for how much testing will cost, federal law requires hospitals to post the cost of tests and procedures online.  No reason to have "no idea" what the costs will be. 

 

Googled "health cost transparency" and these were some of the top hits:  

 

https://news.rice.edu/news/2022/top-hospitals-blatantly-violating-price-transparency-mandate-says-baker-institute-report

 

https://www.beckershospitalreview.com/finance/14-of-hospitals-compliant-with-price-transparency-survey-finds-4-things-to-know.html

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12 minutes ago, DabillsDaBillsDaBills said:

 

 

Cash prices are always maximum prices--and very few insured pay any cash other than standard copays and whatever the deductible they have chosen in their plan.  The negotiated price info is available.  The article you posted from Rice shows that consumers can easily see the pricing differences listed by hospitals in the same city for the same procedure.  Consumers then make a choice based on price, if they wish.  Who would chose the more expensive hospital?

 

Noncompliance with the law does not mean no information can be found.  The other poster claimed he had no idea of cost until he gets a bill.  There's no need for that to be true.  Shop around.  Also, one can easily use one of several apps to see the local Medicare reimbursement for procedures to get an idea of what insurers actually pay the hospital.  Many ways to be savvy about this.

 

 

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1 hour ago, Mango said:

 

No they don't. That isn't even a little true. As somebody who as been chasing some unidentified health issues the last 2 years this is not even close to true. I have had some specialists who spend 15 minutes with me and others who spend an hour. I have had some appointment where I schedule with the doctor and only seen their fellow or PA. I have almost no idea what my testing is going to cost and what my insurance will cover until I receive a bill in the mail. 

Studies confirm this fwiw 

 

https://www.nbcnews.com/news/amp/rcna26984

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7 minutes ago, GoBills808 said:

Studies confirm this fwiw 

 

https://www.nbcnews.com/news/amp/rcna26984

 

 

Mango doesn't even look...so he concluded no one does.  Anyone can look it up and ask the hospital if these are cash prices or negotiated.  Plus they can start the conversation already with the Medicare price info in their hands.

 

Hospitals hat don't give the info you can avoid.  Competition will compel them to comply at some point.

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4 minutes ago, Mr. WEO said:

 

 

Mango doesn't even look...so he concluded no one does.  Anyone can look it up and ask the hospital if these are cash prices or negotiated.  Plus they can start the conversation already with the Medicare price info in their hands.

 

Hospitals hat don't give the info you can avoid.  Competition will compel them to comply at some point.

Just seems obscure to mention the federal mandate without the compliance figures also

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1 hour ago, GoBills808 said:

Just seems obscure to mention the federal mandate without the compliance figures also


I was responding to the claim this info simply cannot be known.  That’s not true.  The law went into effect just  last year.  Poor compliance doesn’t make it impossible to get this info from a hospital.  Pointing out how this can be done fairly simply isn’t obscure. 

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1 hour ago, Nextmanup said:

Is there actually any content in this thread commenting on Kim Pegula's health?

 

It seems to be about everything other than that.

 

 

Agree.  I check in on this thread waiting for news.  Hoping that the news is good.

I do think most fans checking this thread are on a quiet vigil like myself.

As to the other subject lines this thread has become, I'm glad my parents raised me the way they did.

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2 hours ago, Nextmanup said:

Is there actually any content in this thread commenting on Kim Pegula's health?

 

It seems to be about everything other than that.

 

 

Isn't that like every other thread?

 

I'm sure there's a good recipe for Bavarian chocolate cake in the OTA thread. 

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