NP协会在起诉医生协会其实是在搞垄断，不希望NP抢市场, 医生100% 搞垄断，把病人的病当成了赚钱的工具， 🛠️ 垄断了价格，造成了 limited accessibility 医生就说NP没有读过医学院，说NP不应该行医。 也有MD 喜欢NP 的。 可以用NP 干活，用MD 的名义。 医生喜欢贬低NP，有的时候是正确的，但是也有的时候是害怕NP抢了生意。 其实这是趋势。自由言论社会。怎么说都可以。 Case Examples Federal Trade Commission (FTC) Involvement: The FTC has consistently supported expanding the scope of practice for NPs to promote competition and increase access to healthcare. The FTC''''s advocacy includes filing amicus briefs and providing statements to state legislatures arguing against restrictive laws that limit NP practice. Example: In 2014, the FTC submitted comments to the Texas Medical Board, arguing that proposed regulations that limited NPs'''' ability to prescribe medications and provide care independently were anti-competitive and detrimental to public health. North Carolina Board of Dental Examiners v. FTC (2015): While not specifically about NPs, this U.S. Supreme Court case is highly relevant. The Court ruled that the North Carolina Board of Dental Examiners violated antitrust laws by restricting non-dentists from providing teeth-whitening services. This case sets a precedent for challenging state regulatory boards when their actions limit competition without sufficient state oversight. Relevance: The decision underscores that professional regulatory boards dominated by members of the profession they regulate must be careful not to engage in anti-competitive conduct. This precedent can be applied to cases where physician-dominated boards restrict NP practice. Michigan Nurses Association v. Michigan Department of Licensing and Regulatory Affairs (LARA): In 2016, the Michigan Nurses Association filed a lawsuit against LARA and the Michigan Board of Nursing, challenging restrictions on NP practice. The lawsuit argued that the restrictions were unjustified and impeded NPs'''' ability to provide necessary care, particularly in underserved areas. Outcome: While the specific outcomes of this lawsuit were more about pushing legislative change, it highlights the legal strategies NPs can use to challenge restrictive practices. California Association for Nurse Practitioners v. California Medical Board: In California, NPs have frequently advocated for legislative changes to remove practice barriers. While specific lawsuit details may not always be public, advocacy efforts often involve legal challenges against state medical boards that impose restrictive regulations. Example: Legislative efforts in California led to the passing of Assembly Bill 890 in 2020, which allows NPs to practice independently without physician supervision under certain conditions, starting in 2023. This legislative success often follows legal and regulatory challenges.
Legal and Ethical Considerations in NP and Physician Association Lawsuits When a Nurse Practitioner (NP) association sues a physician association, claiming that physicians are trying to create a monopoly to make money, several legal, ethical, and professional issues come into play. Here''''s a concise overview of the situation and its implications: Legal Basis Antitrust Laws: The lawsuit likely invokes antitrust laws, which are designed to prevent monopolies and promote competition. The NP association might argue that restrictive practices or policies by the physician association limit competition, thereby creating a monopoly. Scope of Practice: The NP association may contend that physicians are unduly restricting NPs'''' scope of practice, preventing them from utilizing their full training and education, which can be seen as an attempt to maintain market control and higher incomes for physicians. Ethical Considerations Patient Access and Care: At the heart of the argument is the impact on patient access to care. Restricting NP practice can lead to reduced access to healthcare, especially in underserved areas. The NP association may argue that these restrictions harm public health. Professional Collaboration: Ethical practice in healthcare emphasizes interdisciplinary collaboration. The lawsuit might highlight how restrictive practices undermine this principle and negatively affect patient care. Possible Claims by NP Association Market Restriction: The NP association might claim that the physician association''''s policies or lobbying efforts create barriers that prevent NPs from practicing independently, thus limiting competition. Economic Harm: The NP association could argue that these practices are economically motivated to keep physician incomes higher by limiting the supply of healthcare providers. Public Health Impact: The lawsuit may emphasize how these restrictions decrease healthcare access and quality, particularly in rural or underserved areas where NPs play a crucial role. Possible Defenses by Physician Association Quality of Care: The physician association might argue that restrictions are necessary to ensure high standards of patient care and safety, citing differences in training and education between physicians and NPs. Regulatory Compliance: They might also claim that their actions are in compliance with existing laws and regulations designed to protect public health. Outcomes and Implications Legislative and Regulatory Changes: A successful lawsuit could lead to changes in laws and regulations, expanding NPs'''' scope of practice and reducing barriers to independent practice. Increased Access to Care: Removing restrictive practices could improve access to healthcare services, especially in areas with physician shortages. Professional Dynamics: The lawsuit could alter the dynamics between NPs and physicians, potentially fostering more collaborative relationships or increasing professional tensions. Case Examples Federal Trade Commission (FTC): The FTC has previously supported efforts to reduce barriers to NP practice, arguing that such barriers can limit competition and harm consumers by reducing access to care. State-Level Changes: Some states have already implemented laws granting full practice authority to NPs, often following legal and legislative battles similar to those implied in the lawsuit. Conclusion The lawsuit by the NP association against the physician association centers on crucial issues of market competition, access to care, and professional practice boundaries. The outcome could have significant implications for healthcare delivery, regulatory frameworks, and the professional landscape of healthcare providers. 一个NP说：“NP 帮保险公司省很多钱。MD 很多都退休了， 培训周期又长。供求不平衡。我最近看病人累的够呛 ，这脏活累活医生们愿意低薪干吗？ 一个抑郁症病人，从去年8月份开始找精神科医生看病，我是第一个给他做 initial eval 的。 也就是说，如果没有NP， 他还是找不到人看，从去年八月到今年六月底，差不多一年时间了 一个精神科医生，开诊所收费， 现金 500 / initial ， 300/ follow up，大量的保险都不收。 这个医生的一个病人目前在我这里。因为那个医生不收她的保险了。很好的保险 NP 大大地提高了 医疗的 accessibility 我目前还在看好些个低收入保险的病人。 低收入保险，很多诊所都不收了 NP和医生的反垄断的官司NP 肯定会赢的。 原因： 1. 美帝医疗成本的overhead 越来越高。 2. 美帝总体来说越来越没钱了，整个国家一直在赤字经营 。 3. 医疗风险转嫁到 NP。 4. 美帝人口越来越老化和没钱。 一个医院，把Psych ER的医生换了一半换成NP。 医生一个小时250，NP一个小时50，医院立马节省了80%的钱。雇佣十个NP，节省了400万美金一年。医院几十个科室，每个科室节省四百万，就是一两个亿。每年节省一两个亿，那个医院能不愿意？ 那些Psych ER的医生，一个医生带领几个NP，每个NP，医生可以每个月拿一千美金的supervision 的钱，其实就是医生co sign NP 的病历，等于签字就拿钱，每个月多拿几千美金，医生也愿意。 如果自己开业的私人医生，就更愿意雇佣NP了。 一个PSYCH医生自己开业，雇佣了六个NP，三个诊所，年入六百万美金。自己都不怎么看病人了，做小资本家了。 如果他雇佣医生，直接利润减半。你要是自己开业的医生，你也愿意自己多拿钱。 NP 因为拿着很低的工资（NP拿到的钱只有保险给医生70%），干着医生的entry 脏活累活，压力很大。 我自己这半年以来，压力最大的就是来自一个老医生对我的 PUA 和 bully。 我后来换了工作，目前我的supervisor 是 NP 了。 很 nice。 生活质量大大提高了 NP 要找 NP 做 supervision, 不要掉进坏坏的医生手里。噩梦 NP 每年毕业的毕业生太多了， 所以NP 工资不会怎么涨了”
Institute of Medicine (IOM) Support for Nurse Practitioners (NPs) The Institute of Medicine (IOM), now known as the National Academy of Medicine (NAM), has strongly supported the idea of nurse practitioners (NPs) practicing to their fullest potential. This support is rooted in efforts to improve healthcare access, quality, and efficiency. Key Points from the IOM Report The 2010 IOM report titled "The Future of Nursing: Leading Change, Advancing Health" provides comprehensive recommendations for transforming nursing practice. Here are the key points related to NP practice: Remove Practice Barriers: The IOM recommends that states should remove scope-of-practice barriers so that NPs can practice to the full extent of their education and training. This includes granting NPs the authority to perform assessments, make diagnoses, and prescribe medications without physician oversight. Full Practice Authority: The report advocates for full practice authority for NPs, allowing them to operate independently and provide a wider range of healthcare services, particularly in underserved areas where there may be a shortage of physicians. Interdisciplinary Collaboration: The IOM emphasizes the importance of interdisciplinary collaboration among healthcare professionals. It suggests that NPs, physicians, and other healthcare providers should work together to provide comprehensive and high-quality care. Increase Access to Care: By allowing NPs to practice independently, the IOM believes it can increase access to healthcare, especially in rural and underserved communities where NPs can fill gaps in primary care services. Education and Training: The report also highlights the need for ongoing education and training for NPs to ensure they are equipped with the latest knowledge and skills to provide high-quality care. This includes promoting advanced degrees and continued professional development. Impact on Healthcare Improved Access: Allowing NPs to practice independently can significantly improve access to healthcare services, particularly in areas with physician shortages. Cost-Effective Care: NPs can provide cost-effective care, which can help reduce healthcare costs while maintaining or improving the quality of care. Patient Satisfaction: Studies have shown high levels of patient satisfaction with care provided by NPs, indicating that they are trusted and valued healthcare providers. Challenges and Considerations Legislative Barriers: Despite the IOM’s recommendations, some states still have restrictive laws that limit NP practice. Efforts to advocate for legislative changes continue. Professional Tensions: There may be tensions between physicians and NPs regarding the scope of practice. Promoting mutual respect and understanding between different healthcare professionals is essential. Conclusion The IOM’s support for NPs practicing to their fullest potential is based on evidence that it can improve access to care, enhance the quality of healthcare services, and reduce costs. Continued advocacy and legislative changes are necessary to fully realize these benefits and ensure that NPs can contribute effectively to the healthcare system.
NP协会在起诉医生协会其实是在搞垄断，不希望NP抢市场, 医生100% 搞垄断，把病人的病当成了赚钱的工具， 🛠️ 垄断了价格，造成了 limited accessibility
医生就说NP没有读过医学院，说NP不应该行医。 也有MD 喜欢NP 的。 可以用NP 干活，用MD 的名义。
医生喜欢贬低NP，有的时候是正确的，但是也有的时候是害怕NP抢了生意。
其实这是趋势。自由言论社会。怎么说都可以。
Case Examples
Federal Trade Commission (FTC) Involvement:
The FTC has consistently supported expanding the scope of practice for NPs to promote competition and increase access to healthcare. The FTC''''s advocacy includes filing amicus briefs and providing statements to state legislatures arguing against restrictive laws that limit NP practice.
Example: In 2014, the FTC submitted comments to the Texas Medical Board, arguing that proposed regulations that limited NPs'''' ability to prescribe medications and provide care independently were anti-competitive and detrimental to public health.
North Carolina Board of Dental Examiners v. FTC (2015):
While not specifically about NPs, this U.S. Supreme Court case is highly relevant. The Court ruled that the North Carolina Board of Dental Examiners violated antitrust laws by restricting non-dentists from providing teeth-whitening services. This case sets a precedent for challenging state regulatory boards when their actions limit competition without sufficient state oversight.
Relevance: The decision underscores that professional regulatory boards dominated by members of the profession they regulate must be careful not to engage in anti-competitive conduct. This precedent can be applied to cases where physician-dominated boards restrict NP practice.
Michigan Nurses Association v. Michigan Department of Licensing and Regulatory Affairs (LARA):
In 2016, the Michigan Nurses Association filed a lawsuit against LARA and the Michigan Board of Nursing, challenging restrictions on NP practice. The lawsuit argued that the restrictions were unjustified and impeded NPs'''' ability to provide necessary care, particularly in underserved areas.
Outcome: While the specific outcomes of this lawsuit were more about pushing legislative change, it highlights the legal strategies NPs can use to challenge restrictive practices.
California Association for Nurse Practitioners v. California Medical Board:
In California, NPs have frequently advocated for legislative changes to remove practice barriers. While specific lawsuit details may not always be public, advocacy efforts often involve legal challenges against state medical boards that impose restrictive regulations.
Example: Legislative efforts in California led to the passing of Assembly Bill 890 in 2020, which allows NPs to practice independently without physician supervision under certain conditions, starting in 2023. This legislative success often follows legal and regulatory challenges.
Legal and Ethical Considerations in NP and Physician Association Lawsuits
When a Nurse Practitioner (NP) association sues a physician association, claiming that physicians are trying to create a monopoly to make money, several legal, ethical, and professional issues come into play. Here''''s a concise overview of the situation and its implications:
Legal Basis
Antitrust Laws: The lawsuit likely invokes antitrust laws, which are designed to prevent monopolies and promote competition. The NP association might argue that restrictive practices or policies by the physician association limit competition, thereby creating a monopoly.
Scope of Practice: The NP association may contend that physicians are unduly restricting NPs'''' scope of practice, preventing them from utilizing their full training and education, which can be seen as an attempt to maintain market control and higher incomes for physicians.
Ethical Considerations
Patient Access and Care: At the heart of the argument is the impact on patient access to care. Restricting NP practice can lead to reduced access to healthcare, especially in underserved areas. The NP association may argue that these restrictions harm public health.
Professional Collaboration: Ethical practice in healthcare emphasizes interdisciplinary collaboration. The lawsuit might highlight how restrictive practices undermine this principle and negatively affect patient care.
Possible Claims by NP Association
Market Restriction: The NP association might claim that the physician association''''s policies or lobbying efforts create barriers that prevent NPs from practicing independently, thus limiting competition.
Economic Harm: The NP association could argue that these practices are economically motivated to keep physician incomes higher by limiting the supply of healthcare providers.
Public Health Impact: The lawsuit may emphasize how these restrictions decrease healthcare access and quality, particularly in rural or underserved areas where NPs play a crucial role.
Possible Defenses by Physician Association
Quality of Care: The physician association might argue that restrictions are necessary to ensure high standards of patient care and safety, citing differences in training and education between physicians and NPs.
Regulatory Compliance: They might also claim that their actions are in compliance with existing laws and regulations designed to protect public health.
Outcomes and Implications
Legislative and Regulatory Changes: A successful lawsuit could lead to changes in laws and regulations, expanding NPs'''' scope of practice and reducing barriers to independent practice.
Increased Access to Care: Removing restrictive practices could improve access to healthcare services, especially in areas with physician shortages.
Professional Dynamics: The lawsuit could alter the dynamics between NPs and physicians, potentially fostering more collaborative relationships or increasing professional tensions.
Case Examples
Federal Trade Commission (FTC): The FTC has previously supported efforts to reduce barriers to NP practice, arguing that such barriers can limit competition and harm consumers by reducing access to care.
State-Level Changes: Some states have already implemented laws granting full practice authority to NPs, often following legal and legislative battles similar to those implied in the lawsuit.
Conclusion
The lawsuit by the NP association against the physician association centers on crucial issues of market competition, access to care, and professional practice boundaries. The outcome could have significant implications for healthcare delivery, regulatory frameworks, and the professional landscape of healthcare providers.
一个NP说：“NP 帮保险公司省很多钱。MD 很多都退休了， 培训周期又长。供求不平衡。我最近看病人累的够呛 ，这脏活累活医生们愿意低薪干吗？
一个抑郁症病人，从去年8月份开始找精神科医生看病，我是第一个给他做 initial eval 的。 也就是说，如果没有NP， 他还是找不到人看，从去年八月到今年六月底，差不多一年时间了
一个精神科医生，开诊所收费， 现金 500 / initial ， 300/ follow up，大量的保险都不收。 这个医生的一个病人目前在我这里。因为那个医生不收她的保险了。很好的保险
NP 大大地提高了 医疗的 accessibility
我目前还在看好些个低收入保险的病人。 低收入保险，很多诊所都不收了
NP和医生的反垄断的官司NP 肯定会赢的。 原因： 1. 美帝医疗成本的overhead 越来越高。 2. 美帝总体来说越来越没钱了，整个国家一直在赤字经营 。 3. 医疗风险转嫁到 NP。 4. 美帝人口越来越老化和没钱。
一个医院，把Psych ER的医生换了一半换成NP。 医生一个小时250，NP一个小时50，医院立马节省了80%的钱。雇佣十个NP，节省了400万美金一年。医院几十个科室，每个科室节省四百万，就是一两个亿。每年节省一两个亿，那个医院能不愿意？
那些Psych ER的医生，一个医生带领几个NP，每个NP，医生可以每个月拿一千美金的supervision 的钱，其实就是医生co sign NP 的病历，等于签字就拿钱，每个月多拿几千美金，医生也愿意。
如果自己开业的私人医生，就更愿意雇佣NP了。 一个PSYCH医生自己开业，雇佣了六个NP，三个诊所，年入六百万美金。自己都不怎么看病人了，做小资本家了。 如果他雇佣医生，直接利润减半。你要是自己开业的医生，你也愿意自己多拿钱。
NP 因为拿着很低的工资（NP拿到的钱只有保险给医生70%），干着医生的entry 脏活累活，压力很大。 我自己这半年以来，压力最大的就是来自一个老医生对我的 PUA 和 bully。
我后来换了工作，目前我的supervisor 是 NP 了。 很 nice。 生活质量大大提高了
NP 要找 NP 做 supervision, 不要掉进坏坏的医生手里。噩梦
NP 每年毕业的毕业生太多了， 所以NP 工资不会怎么涨了”
Institute of Medicine (IOM) Support for Nurse Practitioners (NPs)
The Institute of Medicine (IOM), now known as the National Academy of Medicine (NAM), has strongly supported the idea of nurse practitioners (NPs) practicing to their fullest potential. This support is rooted in efforts to improve healthcare access, quality, and efficiency.
Key Points from the IOM Report
The 2010 IOM report titled "The Future of Nursing: Leading Change, Advancing Health" provides comprehensive recommendations for transforming nursing practice. Here are the key points related to NP practice:
Remove Practice Barriers: The IOM recommends that states should remove scope-of-practice barriers so that NPs can practice to the full extent of their education and training. This includes granting NPs the authority to perform assessments, make diagnoses, and prescribe medications without physician oversight.
Full Practice Authority: The report advocates for full practice authority for NPs, allowing them to operate independently and provide a wider range of healthcare services, particularly in underserved areas where there may be a shortage of physicians.
Interdisciplinary Collaboration: The IOM emphasizes the importance of interdisciplinary collaboration among healthcare professionals. It suggests that NPs, physicians, and other healthcare providers should work together to provide comprehensive and high-quality care.
Increase Access to Care: By allowing NPs to practice independently, the IOM believes it can increase access to healthcare, especially in rural and underserved communities where NPs can fill gaps in primary care services.
Education and Training: The report also highlights the need for ongoing education and training for NPs to ensure they are equipped with the latest knowledge and skills to provide high-quality care. This includes promoting advanced degrees and continued professional development.
Impact on Healthcare
Improved Access: Allowing NPs to practice independently can significantly improve access to healthcare services, particularly in areas with physician shortages.
Cost-Effective Care: NPs can provide cost-effective care, which can help reduce healthcare costs while maintaining or improving the quality of care.
Patient Satisfaction: Studies have shown high levels of patient satisfaction with care provided by NPs, indicating that they are trusted and valued healthcare providers.
Challenges and Considerations
Legislative Barriers: Despite the IOM’s recommendations, some states still have restrictive laws that limit NP practice. Efforts to advocate for legislative changes continue.
Professional Tensions: There may be tensions between physicians and NPs regarding the scope of practice. Promoting mutual respect and understanding between different healthcare professionals is essential.
Conclusion
The IOM’s support for NPs practicing to their fullest potential is based on evidence that it can improve access to care, enhance the quality of healthcare services, and reduce costs. Continued advocacy and legislative changes are necessary to fully realize these benefits and ensure that NPs can contribute effectively to the healthcare system.
NP 有些医学教育背景，但主要是按护理专业培养，不然怎么还是用nurse的头衔呢？NP和MD培养的目标不一样。
当然，NP比RN要多些医学知识教育。可以协助医生做些工作。他们可以帮医生开药，化验单等。甚至看一些常见病，感冒等。 但不能等同MD。
有人会说，NP可以看些病，是的，国内的赤脚医生或乡村医生也会看些病，他们也没有医学院教育背景。但和正规医学院临床医学专业毕业的医生不能比。
NP学的太短，新毕业的得配合Google 那个考过美国医生执照考试的医学AI 才放心吧？不知道那些便宜收费的网上医疗是不是背后有这种AI，速度那么快外加那么便宜看病，目前某些连锁大医院用Google generative AI technology.
牙科是有人工智能+3D打印快速做假牙，整牙也有整牙软件。
未来医学可能都是人工智能加持，人出处方和检验单。
现在也有人工智能能加持“伽马刀”“磁波刀”之类不开传统刀选项。 子宫肌瘤现在就有传统开刀，微创宫腔镜，腹腔镜，机器人手术，还有无创伤“磁波刀”
看病还是找MD好，哪怕看发烧，别管给药不给药，MD不会瞎做一些有的没得的检测。NP看感冒，啥检测都做，诊所化验外加实验室化验，还以为是要医学研究呢。算下来一个感冒几百块，比MD贵多了
实质就是资本家赚钱没够，利用NP剥削MD，剥削底下的人。