r/Noctor

Why don’t some pa/np or even other nurses correct their patients when the patient calls them Doctor?
I’ve been working as a RN for a while and I’ve always found it annoying that some professionals don’t identify themselves properly. When a patient says to me “thanks Doctor” or says to their family
Member “the doctor said..” while looking at me — I specifically correct them and say I’m not the doctor I’m the nurse.

Go to school and become an MD instead of pretending.

This is my take, but I've noticed this in myself but in friends and others. But when you are MD is dating a NP/PA and they sort of believe in this hogwash or know people that do you sort of have to moderate a little bit to preserve interpersonal but also working relationships. Also lot of these nurses seem to really believe in nursing theory and believe in their modality of caring or whatever that is an alternative fact/truth to like medical care. Its like an entire ecosystem I feel like you can see when you see all these textbooks written by DNP/NPs or whatever that advocate strongly for the nursing part or whatever. Just spitballing my thoughts, curious what others think

Bit of a rant. I am an RN. I love nursing and am not casting shade to NPs, merely commenting on the quality of midlevel education post-COVID, which is truly frightening.

I have an RN coworker in school to be an NP at a reputable, major institution. She told me she was taking a pharmacology class--all of which was just online lectures and assignments--and she had a question about albumin levels during pregnancy as it relates to pharmacology. When she asked her professor the question, the response she got was "you should use your resources to look into it".

My coworker goes on to tell me she chatGPT'd it for the answer. I was mortified.

Maybe I am out of line here, but first of all, if you are getting an advanced degree in a medical field, watching online lectures ain't gonna do jack-shit. To quote Good Will Hunting, "you dropped 150 grand on a f***ing education you could have got for a dollar fifty in late charges at the public library." Second of all, if youre paying for a degree, your professor better be able to answer you question.

That's all.

Hello, Noctor community!

I'm an occupational therapist working in pediatrics these days, although I've also worked in neuro rehab primarily with patients recovering from CVAs. I've found my career immensely rewarding, and I have tremendous respect for the physicians I've worked alongside.

Many people in my family are physicians, so I've also had considerable exposure to the medical profession outside my own experience. I've seen firsthand how valuable physician advocacy can be, particularly when insurance companies deny or restrict access to rehabilitation services. I've collaborated with physicians to challenge those decisions and help patients obtain necessary care.

I'm curious how this community views OTs and our role within the healthcare system? I have an OTD because I received a scholarship that covered it, however I don't think this should be a required entry level degree for our field. A masters level education for PT and OT is plenty imho. No PT or OT I have ever known has masqueraded themselves as "doctor". I think we would all laugh at anyone who did this as soon as they turn their back.

I've also been thinking about the expanding independent NP practice. If I were an NP, I would personally prefer to work under direct physician supervision, particularly given the differences in clinical training. I'm not entirely sure why an NP would want to practice independently without that oversight. There is no way an NP can make up for the lack of residency and training that doctors have. Why would any NP even want independent practice?

Their training should include substantially more rigorous clinical preparation, ideally something approaching the structure and intensity of physician residency training. I also believe NP licensure should require physician supervision rather than permit independent practice.

I'm interested in hearing your perspectives, both on occupational therapy and on the broader question of appropriate clinical supervision and scope of practice. Thank you!

I have now seen multiple videos of NPs and PAs claiming that they are part of very tough programs that are basically accelerated med-school and they diagnose and treat patients independently and also prescribe medications. Plus that they are no ones assistant. How is that actually possible?
Are they actually allowed to do all these things independently? And if yes, why??
There is no way that these people are qualified to do that after a 2-3 year program.

This comes specifically because of theekieralee‘s video in which she talks about that one girl faking being in PA school.
She goes on to say that she is no ones assistant and says that PA school is very tough because it is med school sped up to two times speed. Like please.

I was at orientation today for my new job at a hospital and the first part of the day all of the new hires were in a big group so there were a bunch of nurses. The main clinical educator was previously a bedside nurse for like 25+yrs. Anyway, we were barely into the day and she was taking primarily to the nurses and new grad nurses who were onboarding and bringing up “working for a year or two and then going to NP school and CRNA school.” To new grads. After she just told us she left bedside, which she loved, because they were so short staffed she was working 60+ hr weeks in the CVICU.

Then she started talking about the period of time the new grad nurses would be supervised and called it residency.” I’m not a resident but I have to work in clinic with residents and I’m offended for them. Why co-opt the language? What does it accomplish? The average patient barely knows what an MD resident is, why the hell are we calling nurses residents?

Maybe it might be prudent to prioritize bedside nursing instead of NP? You know since there’s a massive shortage and all?

To start of I am not a doctor or mid level, am a nobody!

I am surrounded by NPs. I know this DNP who is opening up a clinic. They Complained that it's taken over 6 months which she doesn't understand why because when she was hired the credentialing took 2 weeks. I tell her that is normal and she didn't have any contractual agreement with the payers when she was hired.

they also heard from other NPs in some online group that insurance wants to pay providers so she wants to hire a biller from Indi...a to bill for the highest paying codes. their clinic's taxonomy is primary care. So am like... ahh if your encounter with a pt is for annual check up, there is a cpt code for that and plus insurance doesn't want to pay they will find a reason to reject. she somehow thinks she can just submit the "highest" paying code whatever that means.

that once credentialing is done wound care pays even more money from the payers. im like you can just keep billing over and over again for the same services especially since you are just primary care. each code you billed you must be ready to provide documentation why it's needed. Ever since they got their doctorate in nursing they just see dollar signs. i get it.. we all want money. talk about how their school was hard. I straight up told them their PhD offered no significant advancement in nursing or healthcare. told them they worked two full time jobs while finishing up their PhD it's can't be that hard. just copy paste. i even told them their job can be done by AI. At that point they asked, "so you think AI can wipe ass and give short?". I replied yes and processed to show them the new robotic AI Aletta that is drawing blood without hands-on operator intervention..

i just want you to imagine their face when they saw the AI drawing blood. her jaw to the ground, I could hear gears turning in their head.

Long time lurker but I have seen different viewpoints on residencies in this subreddit. Ive seen comments saying that no one should be stealing the “residency” terminology from MDs and DOs and how midlevels are trying to call certain types of training a “residency.” What do you all think of pharmacy residencies? I am a pharmacy resident currently and I genuinely want to know what other healthcare professionals think of them.

I’m currently going through a crisis myself as I don’t feel satisfied or even useful for that matter as a pharmacist. Like i can dose your vancomycin/warfarin but other hospitals seem to manage just fine without pharmacists dosing these drugs. I understand that’s not the only thing pharmacists do but I’m just giving an example. Do physicians truly find pharmacists helpful?

What is something that you as the physician want pharmacists to do, not do, or do better so as to be more useful to the care team?
I appreciate your thoughts.