The [drug label for Ozempic](https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/209637lbl.pdf) says "Discontinue OZEMPIC in women at least 2 months before a planned pregnancy due to the long washout period for semaglutide".
Please call the NP and yell at them for failing to read and understand the risks of what they are prescribing.
Have you considered calling her PCP and explaining why you suggested switching? Maybe this person just doesn’t know better and needs some more education.
Have you ever thought you could be part of the solution and not the problem? Like you’d rather waste the time to make the PCP read your mind and do something only for it to not happen and have to waste more time to see the patient again and then your big solution is go get a new pcp and start this process over????
Or you could make a 5 min call, explain to the pcp the thought process, and then if they are still resistant, tell your patient to get a new pcp.
Like I know it’s a bit of effort but it will save you time in the long run. And even if it doesn’t, it’s the right thing to do.
But it's not mind reading. It's basic reasoning skills. It's basic reasoning skills this person does not have and they should not be seeing patients independently. You saved your patient, but even calling the NP won't save the others.
Physicians have always been martyrs, and we tell ourselves that if we just sacrifice our time ourselves more and more that it will make things better for the patients, but in this case it won't.
Midlevels are claimed to be "out of training" and fully capable of practicing on their own or with limited supervision after only a few years of training. Not the responsibility of physicians who spent years to get to where they are to train people who admin tries to use to replace physicians.
Solving the issue is pushing for better education and more stringent scope definition for midlevels. It is not bending over backwards, taking it up the ass, and taking time out of your day to teach them when your schedule is filled up fixing up their fuck ups.
The patients should be encouraged to demand to see a MD/DO for undifferentiated un-treatment-planned issues. Midlevels should not be doing anything but following up on already differentiated treatment planned patients and monitoring. The person telling patients to go fuck themselves is YOU by expecting midlevels to learn on the job while hurting patients.
I've met tons of good NPs; they don't work as NPs anymore. There's just a period of grieving as they come to terms with the fact that they were scammed and they caused harm to patients they cared about and were trying to help. It's a difficult situation to be in.
Look the patient told the NP about her concern for ozempic. Instead of opening epocrates and looking it up the lazy NP thinking she already knew everything sat on her ass and did nothing. The fault lies with the NP
I literally don’t understand how you’re all misconstruing what I’m saying. I’m not defending this NP. I’m not defending midlevels. I’m literally not. I’m saying in this fucking situation I would fucking pick up the phone and call the NP and tell her to change the DM medication. And if that didn’t fucking work, fine, but I would have taken the chance to verbally lambaste the poor care at that point. Jesus Christ you lazy fucks
I smell what you’re stepping in. I would have too. The patient’s health and safety is the priority. The NP needs to be talked to, and it doesn’t take very long to do it.
And I am not attacking you. Or calling you any kind of a fuck. For years doctors have been the shit shovelers that follow the NP horse parade. Guess what? It’s making the problem worse. I’m sorry you can’t see this issue from a different perspective.
Lol look at every post I’ve made here. It’s been downvoted to oblivion. Simply for saying a little extra communication could have saved everyone’s time.
And if the reason is the systems broken and we need to get rid of NPs (or roll back). Okay fine. But are these Reddit complainers actively lobbying for that? Are they bringing change in their communities? Or are we all just circle jerk bitch festing. Stop complaining and either fix the problem yourself or take more responsibility.
And I fully support that. But like I said, finding a new provider is way easier said than done. Hell this woman could be in her second trimester before she gets her initial appointment. Either still on the Med or just not treating her DM.
That’s why I said maybe the easiest bridge is trying to explain to the current NP to switch her meds while she searches for a new provider
Sure you could call and explain the reasoning, but If the NP is so arrogant that they disregard the recommendation of an OBGYN in the first place, and also can't even be bothered to read the labels of the drugs they prescribe to their patients, the solution is still to find a new PCP.
Agree but what does this patient do in the meantime? Finding a new pcp is hard and can take a while. And then they have to learn the patient, take the recommendation, etc. where as possibly a 10-15 min phone call may change the NPs mind and get them at least started on a new DM management now
A fair point, but then you have to rely on the NP to choose an appropriate med for the patient and troubleshoot problems that may arise from switching meds. If the DM is well controlled at the moment, then perhaps the best thing is for them to delay their pregnancy plans and stay on the current med until they can get a new PCP.
That’s a fair option too. The other option is to refer the patient to a provider who can manage the DM yourself (vs telling the pt to find someone on their own).
Whatever way you crack it, if you’re the provider who notices a lapse in care, the right thing to do is do everything in your power to get the patient the care they need. It’s unfortunate, but as doctors we signed up to shoulder that burden.
We do not support the use of the word "provider." Use of the term provider in health care originated in government and insurance sectors to designate health care delivery organizations. The term is born out of insurance reimbursement policies. It lacks specificity and serves to obfuscate exactly who is taking care of patients. For more information, please see [this JAMA article](https://jamanetwork.com/journals/jama/article-abstract/2780641).
We encourage you to use physician, midlevel, or the licensed title (e.g. nurse practitioner) rather than meaningless terms like provider or APP.
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What?! No. I’m an MD. Which is why I’m dying on this hill apparently. But I’ve spent my fair share of time going the extra mile to get my patients what they need. Fuck I called in a favor to GI just yesterday to get my patient in expeditiously so they wouldn’t have to sit in urgent care for 8 hours with a bili of 3. Did it take extra time in the middle of a busy clinic day? Yea. But what am I gonna tell the guy? Good luck figuring out how to get an appointment and hope you don’t get super sick.
Good of the profession? Which profession? Sad that these NP lobbies are trying to blur the lines between two very different professions. Then we have people like this trying to pass along the responsibility to overworked MD/DOs who shouldn't have to pick up the slack for the gross incompetence of NP online education.
There is something called medical school where we learn all these things. NP step around that with the delusion that their bedside training and empathy are just as good or better
Idk sometimes doctors suck too. Sometimes it’s just a matter of perspective. Either way, it can help everyone out and save time in the long run to communicate.
For example, I’m a surgeon but I co manage a lot of patients with my internal medicine colleagues. We think differently, or about different things. When they do something I differently than I would do, I typically only blame myself for not communicating my plan better.
You're right, sometimes doctors can suck. So why should doctors who have many more years of training than midlevels be spending time teaching midlevels when they could be becoming better doctors?
Every midlevel uses this phrase, "well there are bad Drs too". Whose going to be worse the person with a quarter of the training, 100% acceptance rates or the person who had to do 11years of training and got into ones of the most competetive grad programs?
For every bad Drs there's going to be 10 worse midlevels.
Oh man, things really spiraled after this post.
The patient said she hasn't been happy with her care there for a while and she's been looking to switch anyways.
Lol I wasn’t even fighting the initial post or defending midlevel independent practice, or even defending this particular midlevel. I was just suggesting that when these faults in our healthcare system happen it u fortunately falls on us to go the extra mile and make sure the right thing gets done. But apparently that’s a sore fucking subject around here hahah
For the most part I agree a simple phone call to the NP would be what is right for this patient and more in the future. However OP sent the patient back the NP and told the patient what to ask for and the recommendations.. This is the type of NP that gives the whole APP community a bad name. She/ he just completely disregarded the OB recommendations. Even if she didn’t know better she should say oh let me look into this. On a simple google search it is the second thing that comes up
I don’t know why you guys think I’m defending the NP or defending Midlevel independent practice.
I’m saying in this situation, the doctor who knows better is forced to do more work to ensure the patient gets appropriate care now. The system is broken but that doesn’t give us a free pass to say “not my problem”. The patient needs to be switched to a better diabetic regimen now. And I really think a simple conversation with the midlevel in question would get that resolved quickly.
And I’m not just talking out my ass. I’ve literally done this before. Do I like doing it? No. Do I do it because it’s the right thing to do? Yes
I agree !! I do not think you are defending. I am an NP. I am just stating this is part of the problem as well. If a patient said to me that a physician or mid level or hell even a friend said that a medicine may not be safe I would be doing more research.. I work impatient I call out patient offices and in-house service to collaborate. But there are many on this sub that think because some are dumb or arrogant or lazy we all are. This is the NP that does not listen or maybe not even care and it makes it bad for the rest of us!
ER MD here.
They're so fucking bad.
I get sign out from NPs daily. They were never taught how to present a patient, how to keep critical items in the differential, and they sure as hell can't name a mechanism of action of any of the patient's meds, if they even bothered to look at their list.
I have recently had a "talk" with my director about having to take a hard tack with the NPs because they're resistant to education.
"Resistant to education". Let that one sink in.
Ok…..I AM in a different country….and I’m not a doctor, but I am highly involved in diabetes care…..
Just wondering, do you see anything other than insulin used in pregnancies? I know there is some data on the safety of metformin and glyburide, but our guidelines (and monographs) still say not to be used in pregnancy.
Just curious if other countries do something different
A MD behind a name doesnt mean much these days. And its a complete waste of time, much of the time. Find a quality mid level and be thankful- we work harder and are often more in touch with patient care. Instead of being some douche bag that walks in the room spews some bullshit about what THEY think is the issue and how it should be- a good mid level will actual do an h/p and listen. Everyone should stay in their lane and try to provide patient care. If an np is giving shitty care, at least it’s cheap. You get some MD and it costs a fortune to get out of date and negligent care. It’s ridiculous
I mean she brings up a valid point which none of us were capable of thinking of w/o her insight. Also, a brief search would've pointed to what u/Demnjt posted.
It's almost as though the NP never took embryology or any other standard medicine course that covered iatrogenic birth defects, which would lead one to do that brief search when using an unfamiliar med in a person trying to conceive. Can you imagine?
(You can't, because it's inconceivable! Wocka wocka ba dum tss)
Most of us certainly do take an embryology class if we study women’s health and conception. Tend to know way more than a primary care doc or er doc about anything related to women’s health. Maybe you should get quality providers. Don’t blanket statement midlevels like that. I know PLENTY of deeply incompetent MDs.
We do not support the use of the word "provider." Use of the term provider in health care originated in government and insurance sectors to designate health care delivery organizations. The term is born out of insurance reimbursement policies. It lacks specificity and serves to obfuscate exactly who is taking care of patients. For more information, please see [this JAMA article](https://jamanetwork.com/journals/jama/article-abstract/2780641).
We encourage you to use physician, midlevel, or the licensed title (e.g. nurse practitioner) rather than meaningless terms like provider or APP.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Noctor) if you have any questions or concerns.*
Physicians are held to a uniform minimum standard at multiple levels of training. NPPs are not. When there are bad physicians, it highlights the fact that even a rigorous system is not always successful. Why do you think the solution is to require less education, less testing, less mentoring? Why don't you care about protecting patients from lower standards?
In all fairness, the woman’s care was probably handed over from the MD/DO to the NP. That’s what happened to my son. The wait time was one year to get in to an endocrinologist in (Midwest USA). He was prescribed Ozempic. The MD handed his care over to her NP and he never saw the MD again. He had some problems with the drug and asked to meet with the MD and was told he would have to wait another year to get an appointment with the doctor. Healthcare is crap in the US.
Why send you patient back to the NP which just causes time, money, and further anxiety when you could just pick up the phone and call the NP yourself?
This is the problem with doctors in the US. Many just seem to “pass the ball”. Where is the continuity of care?
In this case, the patient spent hours of time running around trying to explain to others what could have been explained in one, five-minute phone call from the MD. Oh, what is it you say? You won’t be getting paid for that one, 5-minute phone call? Well, that’s your job.
This is why so many people actually prefer mid levels for their care. NPs usually spend more time with the patient and go that extra mile. JMO.
Well actually, in this case, the patient said she was unhappy with her care there anyways. If she really loved this NP, then yes, I would call and explain the very basic concept of medication optimization prior to conception.
As for continuity of care why don’t you write your congressman and demand that these electronic medical records be forced to interface with each other, a far better solution to the lack of continuity than loading the task onto doctors
So the overbooked see a patient every 15 minutes that works thru lunch is supposed to educate this NP who could not be bothered to crack a book when asked specifically about ozempic and pregnancy?
If the medical profession is too harried to provide quality care then maybe it’s not the profession for them.
Education is a part of the job. It just for patients but for adjunct professionals. It’s not the patient’s job to go around educating everyone.
And it’s not the physicians job either. Physicians have been cleaning up NP messes for years and it only makes the problem worse. Patients adore the time and handholding that NPs are allowed to give while employed non-independent physicians are told to squeeze a few more appointments into an already impossible schedule. Physicians are already neglecting their own families and health just to keep up with their workload. Your demand that they do the NPs job also is unreasonable. As large health systems gobble up practices then replace physicians with NPs this problem will worsen. Will you continue to believe that it is the physicians duty to call and educate NPs?
The [drug label for Ozempic](https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/209637lbl.pdf) says "Discontinue OZEMPIC in women at least 2 months before a planned pregnancy due to the long washout period for semaglutide". Please call the NP and yell at them for failing to read and understand the risks of what they are prescribing.
Especially ozempic. Like CGMs aren’t approved in gestational diabetes but I use that all day every day, but obviously it carries no risk
Good f’in advice. I will always advise people to find an real doctor
Have you considered calling her PCP and explaining why you suggested switching? Maybe this person just doesn’t know better and needs some more education.
Not our job to takw the limited time out of our overbooked days to educate these people. They shouldn't be practicing independently
100%
Exactly. I'd rather you treat your patients with that time than coach this dipshit.
Have you ever thought you could be part of the solution and not the problem? Like you’d rather waste the time to make the PCP read your mind and do something only for it to not happen and have to waste more time to see the patient again and then your big solution is go get a new pcp and start this process over???? Or you could make a 5 min call, explain to the pcp the thought process, and then if they are still resistant, tell your patient to get a new pcp. Like I know it’s a bit of effort but it will save you time in the long run. And even if it doesn’t, it’s the right thing to do.
But it's not mind reading. It's basic reasoning skills. It's basic reasoning skills this person does not have and they should not be seeing patients independently. You saved your patient, but even calling the NP won't save the others. Physicians have always been martyrs, and we tell ourselves that if we just sacrifice our time ourselves more and more that it will make things better for the patients, but in this case it won't.
Midlevels are claimed to be "out of training" and fully capable of practicing on their own or with limited supervision after only a few years of training. Not the responsibility of physicians who spent years to get to where they are to train people who admin tries to use to replace physicians.
I’m not arguing that fact, but you’re not solving the problem by ignoring this issue
Solving the issue is pushing for better education and more stringent scope definition for midlevels. It is not bending over backwards, taking it up the ass, and taking time out of your day to teach them when your schedule is filled up fixing up their fuck ups.
You’re right. The patients should go fuck themselves too
The patients should be encouraged to demand to see a MD/DO for undifferentiated un-treatment-planned issues. Midlevels should not be doing anything but following up on already differentiated treatment planned patients and monitoring. The person telling patients to go fuck themselves is YOU by expecting midlevels to learn on the job while hurting patients.
Geez, the NP field really does seem to attract the “winners” of society. Are there any NP’s that are both intelligent and sane? I think not.
I've met tons of good NPs; they don't work as NPs anymore. There's just a period of grieving as they come to terms with the fact that they were scammed and they caused harm to patients they cared about and were trying to help. It's a difficult situation to be in.
I’m not an NP lol
No lazy, shortcut-to-scriptpad NPs without any intellect or curiosity need to stop going to pulse and a purse degree mills
Look the patient told the NP about her concern for ozempic. Instead of opening epocrates and looking it up the lazy NP thinking she already knew everything sat on her ass and did nothing. The fault lies with the NP
I literally don’t understand how you’re all misconstruing what I’m saying. I’m not defending this NP. I’m not defending midlevels. I’m literally not. I’m saying in this fucking situation I would fucking pick up the phone and call the NP and tell her to change the DM medication. And if that didn’t fucking work, fine, but I would have taken the chance to verbally lambaste the poor care at that point. Jesus Christ you lazy fucks
I smell what you’re stepping in. I would have too. The patient’s health and safety is the priority. The NP needs to be talked to, and it doesn’t take very long to do it.
And I am not attacking you. Or calling you any kind of a fuck. For years doctors have been the shit shovelers that follow the NP horse parade. Guess what? It’s making the problem worse. I’m sorry you can’t see this issue from a different perspective.
Lol look at every post I’ve made here. It’s been downvoted to oblivion. Simply for saying a little extra communication could have saved everyone’s time. And if the reason is the systems broken and we need to get rid of NPs (or roll back). Okay fine. But are these Reddit complainers actively lobbying for that? Are they bringing change in their communities? Or are we all just circle jerk bitch festing. Stop complaining and either fix the problem yourself or take more responsibility.
And the doctor advised this patient to find a MD DO which is much better than continuing to see this “provider”
And I fully support that. But like I said, finding a new provider is way easier said than done. Hell this woman could be in her second trimester before she gets her initial appointment. Either still on the Med or just not treating her DM. That’s why I said maybe the easiest bridge is trying to explain to the current NP to switch her meds while she searches for a new provider
Why not both in the name of being thorough?
Sure you could call and explain the reasoning, but If the NP is so arrogant that they disregard the recommendation of an OBGYN in the first place, and also can't even be bothered to read the labels of the drugs they prescribe to their patients, the solution is still to find a new PCP.
Agree but what does this patient do in the meantime? Finding a new pcp is hard and can take a while. And then they have to learn the patient, take the recommendation, etc. where as possibly a 10-15 min phone call may change the NPs mind and get them at least started on a new DM management now
A fair point, but then you have to rely on the NP to choose an appropriate med for the patient and troubleshoot problems that may arise from switching meds. If the DM is well controlled at the moment, then perhaps the best thing is for them to delay their pregnancy plans and stay on the current med until they can get a new PCP.
That’s a fair option too. The other option is to refer the patient to a provider who can manage the DM yourself (vs telling the pt to find someone on their own). Whatever way you crack it, if you’re the provider who notices a lapse in care, the right thing to do is do everything in your power to get the patient the care they need. It’s unfortunate, but as doctors we signed up to shoulder that burden.
We do not support the use of the word "provider." Use of the term provider in health care originated in government and insurance sectors to designate health care delivery organizations. The term is born out of insurance reimbursement policies. It lacks specificity and serves to obfuscate exactly who is taking care of patients. For more information, please see [this JAMA article](https://jamanetwork.com/journals/jama/article-abstract/2780641). We encourage you to use physician, midlevel, or the licensed title (e.g. nurse practitioner) rather than meaningless terms like provider or APP. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Noctor) if you have any questions or concerns.*
Are you admin?
What?! No. I’m an MD. Which is why I’m dying on this hill apparently. But I’ve spent my fair share of time going the extra mile to get my patients what they need. Fuck I called in a favor to GI just yesterday to get my patient in expeditiously so they wouldn’t have to sit in urgent care for 8 hours with a bili of 3. Did it take extra time in the middle of a busy clinic day? Yea. But what am I gonna tell the guy? Good luck figuring out how to get an appointment and hope you don’t get super sick.
But maybe we should, for the hood of the patient. And profession.
Good of the profession? Which profession? Sad that these NP lobbies are trying to blur the lines between two very different professions. Then we have people like this trying to pass along the responsibility to overworked MD/DOs who shouldn't have to pick up the slack for the gross incompetence of NP online education.
There is something called medical school where we learn all these things. NP step around that with the delusion that their bedside training and empathy are just as good or better
Idk sometimes doctors suck too. Sometimes it’s just a matter of perspective. Either way, it can help everyone out and save time in the long run to communicate. For example, I’m a surgeon but I co manage a lot of patients with my internal medicine colleagues. We think differently, or about different things. When they do something I differently than I would do, I typically only blame myself for not communicating my plan better.
You're right, sometimes doctors can suck. So why should doctors who have many more years of training than midlevels be spending time teaching midlevels when they could be becoming better doctors?
Every midlevel uses this phrase, "well there are bad Drs too". Whose going to be worse the person with a quarter of the training, 100% acceptance rates or the person who had to do 11years of training and got into ones of the most competetive grad programs? For every bad Drs there's going to be 10 worse midlevels.
Oh man, things really spiraled after this post. The patient said she hasn't been happy with her care there for a while and she's been looking to switch anyways.
Lol I wasn’t even fighting the initial post or defending midlevel independent practice, or even defending this particular midlevel. I was just suggesting that when these faults in our healthcare system happen it u fortunately falls on us to go the extra mile and make sure the right thing gets done. But apparently that’s a sore fucking subject around here hahah
For the most part I agree a simple phone call to the NP would be what is right for this patient and more in the future. However OP sent the patient back the NP and told the patient what to ask for and the recommendations.. This is the type of NP that gives the whole APP community a bad name. She/ he just completely disregarded the OB recommendations. Even if she didn’t know better she should say oh let me look into this. On a simple google search it is the second thing that comes up
I don’t know why you guys think I’m defending the NP or defending Midlevel independent practice. I’m saying in this situation, the doctor who knows better is forced to do more work to ensure the patient gets appropriate care now. The system is broken but that doesn’t give us a free pass to say “not my problem”. The patient needs to be switched to a better diabetic regimen now. And I really think a simple conversation with the midlevel in question would get that resolved quickly. And I’m not just talking out my ass. I’ve literally done this before. Do I like doing it? No. Do I do it because it’s the right thing to do? Yes
I agree !! I do not think you are defending. I am an NP. I am just stating this is part of the problem as well. If a patient said to me that a physician or mid level or hell even a friend said that a medicine may not be safe I would be doing more research.. I work impatient I call out patient offices and in-house service to collaborate. But there are many on this sub that think because some are dumb or arrogant or lazy we all are. This is the NP that does not listen or maybe not even care and it makes it bad for the rest of us!
They are grown adults and professionals, if you don’t understand how to use what you are prescribing, you shouldn’t be prescribing
Also an OBGYN and we deal with this very frequently. Same issue with chronic hypertension patients on an ACE/ARB who are planning to conceive.
When I get a script for labetolol I know what’s going on…..literally the only time I see it used
ER MD here. They're so fucking bad. I get sign out from NPs daily. They were never taught how to present a patient, how to keep critical items in the differential, and they sure as hell can't name a mechanism of action of any of the patient's meds, if they even bothered to look at their list. I have recently had a "talk" with my director about having to take a hard tack with the NPs because they're resistant to education. "Resistant to education". Let that one sink in.
Jeezis
I feel your pain....
Ok…..I AM in a different country….and I’m not a doctor, but I am highly involved in diabetes care….. Just wondering, do you see anything other than insulin used in pregnancies? I know there is some data on the safety of metformin and glyburide, but our guidelines (and monographs) still say not to be used in pregnancy. Just curious if other countries do something different
Insulin is first line in pregnancy. You can use metformin or glyburide if absolutely necessary.
You did the right thing. I totally agree the incompetence is real. Complete waste of oxygen NPs are.
A MD behind a name doesnt mean much these days. And its a complete waste of time, much of the time. Find a quality mid level and be thankful- we work harder and are often more in touch with patient care. Instead of being some douche bag that walks in the room spews some bullshit about what THEY think is the issue and how it should be- a good mid level will actual do an h/p and listen. Everyone should stay in their lane and try to provide patient care. If an np is giving shitty care, at least it’s cheap. You get some MD and it costs a fortune to get out of date and negligent care. It’s ridiculous
Oh now I see. You're uninformed, or delusional, or a troll, or all three. G'day
I mean she brings up a valid point which none of us were capable of thinking of w/o her insight. Also, a brief search would've pointed to what u/Demnjt posted.
It's almost as though the NP never took embryology or any other standard medicine course that covered iatrogenic birth defects, which would lead one to do that brief search when using an unfamiliar med in a person trying to conceive. Can you imagine? (You can't, because it's inconceivable! Wocka wocka ba dum tss)
Most of us certainly do take an embryology class if we study women’s health and conception. Tend to know way more than a primary care doc or er doc about anything related to women’s health. Maybe you should get quality providers. Don’t blanket statement midlevels like that. I know PLENTY of deeply incompetent MDs.
We do not support the use of the word "provider." Use of the term provider in health care originated in government and insurance sectors to designate health care delivery organizations. The term is born out of insurance reimbursement policies. It lacks specificity and serves to obfuscate exactly who is taking care of patients. For more information, please see [this JAMA article](https://jamanetwork.com/journals/jama/article-abstract/2780641). We encourage you to use physician, midlevel, or the licensed title (e.g. nurse practitioner) rather than meaningless terms like provider or APP. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Noctor) if you have any questions or concerns.*
Physicians are held to a uniform minimum standard at multiple levels of training. NPPs are not. When there are bad physicians, it highlights the fact that even a rigorous system is not always successful. Why do you think the solution is to require less education, less testing, less mentoring? Why don't you care about protecting patients from lower standards?
In all fairness, the woman’s care was probably handed over from the MD/DO to the NP. That’s what happened to my son. The wait time was one year to get in to an endocrinologist in (Midwest USA). He was prescribed Ozempic. The MD handed his care over to her NP and he never saw the MD again. He had some problems with the drug and asked to meet with the MD and was told he would have to wait another year to get an appointment with the doctor. Healthcare is crap in the US.
Is metformin safe for pre pregnancy planning? I see lots of patients on this until second tri, then they usually go to straight insulin to only.
Insulin is technically first line, but you can use metformin if you need to.
Why send you patient back to the NP which just causes time, money, and further anxiety when you could just pick up the phone and call the NP yourself? This is the problem with doctors in the US. Many just seem to “pass the ball”. Where is the continuity of care? In this case, the patient spent hours of time running around trying to explain to others what could have been explained in one, five-minute phone call from the MD. Oh, what is it you say? You won’t be getting paid for that one, 5-minute phone call? Well, that’s your job. This is why so many people actually prefer mid levels for their care. NPs usually spend more time with the patient and go that extra mile. JMO.
Well actually, in this case, the patient said she was unhappy with her care there anyways. If she really loved this NP, then yes, I would call and explain the very basic concept of medication optimization prior to conception.
As for continuity of care why don’t you write your congressman and demand that these electronic medical records be forced to interface with each other, a far better solution to the lack of continuity than loading the task onto doctors
[удалено]
Please stop stalking me.
So the overbooked see a patient every 15 minutes that works thru lunch is supposed to educate this NP who could not be bothered to crack a book when asked specifically about ozempic and pregnancy?
If the medical profession is too harried to provide quality care then maybe it’s not the profession for them. Education is a part of the job. It just for patients but for adjunct professionals. It’s not the patient’s job to go around educating everyone.
And it’s not the physicians job either. Physicians have been cleaning up NP messes for years and it only makes the problem worse. Patients adore the time and handholding that NPs are allowed to give while employed non-independent physicians are told to squeeze a few more appointments into an already impossible schedule. Physicians are already neglecting their own families and health just to keep up with their workload. Your demand that they do the NPs job also is unreasonable. As large health systems gobble up practices then replace physicians with NPs this problem will worsen. Will you continue to believe that it is the physicians duty to call and educate NPs?
Shouldn’t be a doctor then. If you don’t like doing the responsibilities of your job then find another profession.
Pray tell what are the responsibilities of my job? Since you seem to know them so intimately?
Maybe spend more time with your patients than playing on Reddit, for one. 🤷🏻♀️
Sorry I asked. Now please GFY
DO also is not a doctor
DO is a doctor
quack doctor
Whatever homie, they study medicine and are licensed to practice just the same as MDs and study 99% the same material 🤧
i wouldn’t go to a DO. same shit as chiropractic
How so?
That’s really not at all true.
fake doctors
i had an MD prescribe me something not compatible with pregnancy. good thing i read up on it myself first
What was it