What brought me here (hello!)
I thought I'd share my own experience so ppl know where I'm coming from and why I am on these threads.
My spouse recently retired. He has metastasized cancer and some other health conditions. We moved from a state with very good medical care and regulation to one that is not-so-good. We did not know what we were getting into at the time. The new state looked like a good place to retire. We are both scientists with advanced degrees, and a lot of interesting research experience. Not everyone finds our research as interesting as we do, so I'll spare you the details.
My spouse had a stroke several months ago, in addition to his existing cancer and other conditions. I started taking over for him and coordinating his care after the stroke.
The actual DOs and MDs that we've found and seen here in the new state have been great - competent, informative, and willing to talk to us and make sure we understand what is going on. They are not at all put off by our technical questions, instead they seem happy to nerd out on us. The actual nurses have also been wonderful. They have a lot of very useful tacit knowledge, can clarify questions about medications and day to day care and advocate for my spouse's comfort and care. These nurses work closely with the MD's on their teams and have existing professional relationships with his doctor (an actual doctor).
However it took an unreal amount of working through and around a corporate healthcare system to get to this point where he can receive competent care. Initially there were a lot of appointments with people who were not doctors. What they were was extremely confusing.
We each have numerous friends who went to Medical School and we're aware of the level of qualification, experience, time and effort required to get a medical specialty like Neurology, cardiology, Internal Medicine, etc.
His "Neurologist" follow-up was with some sort of nurse with a lot of letters listed after her name. The man has cancer and had a stroke so I was expecting a fairly detailed and competent follow-up. The nurse was a surprise, but they're supposedly working under close supervision, right?
She waved her fingers in his face, described his stroke using a technical label that matched NONE of the descriptions from any of the actual doctors we'd spoken with in the hospital (including a neurosurgeon, a neurologist, and a few others). When I called her on that she got defensive and tried unconvincingly to assert that they were the same thing. I have a pretty refined BS detector and it was starting to ping. I had to spell out some of his prescriptions and tell her what they did. She kept him on a medication that we later found was around 4x the dose recommended for his condition, and that can have nasty side effects at that dose for someone with advanced cancer. No sign of the Neurologist anywhere. Yikes!
I was perplexed enough by the compete absence of doctor and the BS level from the nurse-with-too-many-letters to look her up online. She was listed as a "Neurologist NP", but had at most a few months working with the Neurologist. Neurology is not an easy nor quick specialty, so how can a nurse become a neurologist just 4 months after leaving an entirely different practice? How can a nurse become a neurologist at all?
Next up - cardiology. He has a structural heart condition and with everything else going on we wanted to make sure we consulted a cardiologist. He was also having a bad reaction to one of his medications. Again we were seen by a nurse with a lot of letters after her name. Again I had to spell out and explain his medications to her. Again the exam was shockingly cursory, she tried to throw technical argle bargle around without making sense and set off that BS detector. She adjusted his medication.
Again when we later discussed with an actual doctor, we discovered that her medication recommendations were dangerous. And again I was left wondering about the time, training, talent and effort required for a doctor to become a cardiologist. How can a nurse be listed as a cardiologist anything at all? And practicing with zero evidence of supervision?
There are a few more shocking Noctors that we encountered, every single one happily and confidently providing bad prescriptions and bad medical advice - wrong antibiotics that could harm him, weird dietary advice that actually harmed the Noctor (and she continued anyway!) and others. We're in a very thoroughly Noctored area.
Trying to understand what these shockingly incompetent nurses with alphabet soup credentials actually were, and why they were involved in my spouse's complex medical care led me to these threads.
We did get him to actual doctors and now have wonderful experienced actual nurses, working with actual doctors, helping with his care. I am left wondering about the Noctors, though.