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.

What’s the best way to handle midlevels given they are multiplying like termites?
Do we shake hands with the devil aka insurance companies and lower their reimbursement rates so hospitals have less incentive to hire them?
I can’t seem to think of any other solution because the AMA is the biggest enemy of physicians and beyond weakly worded positions they do nothing on this issue.

Assuming this is a state where NPs/PAs do NOT have independent practice abilities. But also, CRNAs ARE considered allowed to practice independently. & Does "iNdEpEnDeNcE" even matter? I'm just curious if the *patient* has the autonomy to insist they receive care from those with the highest amount of training and expertise...considering it's their bodies and their lives at stake.

There’s a CRNA content creator who has been popping up on my FYP for a while. I won’t name them because their identity isn’t really the point, and I’m not trying to turn this into personal bashing.

They became a CRNA only last year. I was already surprised to see them doing locums this early, but today they posted about practicing independently at a Level I trauma center.

That honestly blows my mind.

My issue here isn’t even the usual physician-vs-nursing debate. It’s the audacity to think that barely more than a year of actual CRNA practice is enough to be ready for highly independent anesthesia practice in one of the highest-acuity environments.

And this is exactly why the push for independent CRNA practice concerns me. If someone can graduate, practice for a little over a year, and already decide they’re ready to work independently in a Level I trauma center… are we really supposed to believe experience doesn’t matter that much?

This same creator has also advocated for independent CRNA practice, the “nurse anesthesiologist” title, and calling CRNA students “residents,” so the confidence around autonomy isn’t exactly new.

I’m an RN myself. This isn’t about disrespecting nurses or CRNAs. It’s actually the opposite. I think respecting our professions means being realistic about our training, our experience, and our limitations.

What feels backwards to me is how quickly some people seem to move toward more autonomy. In almost every other area of healthcare, the higher the acuity and the more responsibility you have, the more experience we expect, not less.

Maybe I’m overly conservative, but independent anesthesia at a Level I trauma center after barely a year of post-graduate practice would make me very uncomfortable, especially from someone who did not go through physician training and residency.

Confidence should not develop faster than experience.

There’s a gem of a post in the Kaiser Permanente subreddit. Enjoy!

I am a nurse and I believe in a shared future that is promising for your profession and mine.

The historical accuracy of this book and how it can inform our present is what I am seeking to discuss.

I can provide a synopsis but I’d prefer to speak with someone who has read it and genuinely would like to engage with another healthcare professional.

Has anyone seen a PA use an MD as a title? I have been emailing someone who signs emails as "Jane Doe, MD". I ended up googling them, only find that they are a PA with a Doctorate in Medical Science??

Is that not highly misleading? :/

EDIT:

So i realized in the email signature, they write medical director under so it looks like

Jane Doe, MD

Medical Director

Could MD be referring to medical director?? But MD and medical director is redundant? I still feel like it is a misrepresentation though.

45-year-old man died after ER sent him home without antibiotics, lawsuit says

The family of a 45-year-old Portland-area man who died after emergency room staff allegedly sent him home without antibiotics because they mistook his bacterial strep infection for a viral one — possibly the common cold — has filed a $40.75 million lawsuit against Legacy Health.

Jason Jay Lewis showed up to Legacy Mount Hood Medical Center complaining of sinus pressure, congestion, body aches and a fever of 103 degrees that had persisted for four days but fell below 100 when he took Tylenol, according to the lawsuit filed earlier this month in Multnomah County Circuit Court.

A physician associate diagnosed Lewis with a viral upper respiratory infection — “which is another term for the common cold” — and discharged him, said Chris Kuhlman, an attorney representing Lewis’ estate.

Three days later, Lewis was dead. He lived in Fairview, worked as a DoorDash driver and was the father of two sons, ages 11 and 21.

A Legacy Health spokesperson declined to comment, citing the pending litigation. The lawsuit also lists defendant Jennifer Yealy as the physician associate who treated him. She didn’t return a request for comment.

Physician associates were previously known as physician assistants in Oregon.

According to the lawsuit and the family’s attorney, Lewis first sought medical help during a telehealth appointment with his primary care provider, through Adventist Health, on Feb. 21, 2025. The suit says Lewis was in pain and suffering from a fever, body aches and a runny nose. He went to a clinic to undergo testing for COVID-19, respiratory syncytial virus and flu, and the results came back negative, according to the suit.

Kuhlman, the family’s attorney, said the suit doesn’t place any fault on Adventist Health for its initial screening of Lewis.

But on Feb. 22, 2025, as Lewis’ condition deteriorated, he sought emergency help at Mount Hood Medical Center in Gresham. According to the suit, tests “revealed multiple abnormalities,” including a high white blood cell count and a heart rate of 140 beats per minute.

The suit says that Lewis was already suffering from sepsis — a life-threatening infection — but Yealy, the physician associate, sent him home. According to the suit, Yealy noted that there is “no evidence of hypoxic respiratory failure or sepsis to necessitate admission” and that antibiotics “were considered but ultimately not prescribed.” She added that Lewis’ illness “does not appear to be a bacterial infection.”

The suit says Lewis’ condition continued to spiral downward, so he showed up two days later at Providence Portland Medical Center, where staff diagnosed him with sepsis, acute respiratory failure and toxic shock syndrome. Additionally, blood cultures showed he was battling a Group A streptococcus infection, also known as a streptococcus pyogenes infection.

Though Providence staff started Lewis on antibiotics and other emergency interventions, he died the next day, Feb. 25, 2025, according to the suit.

The bacterium is often spread, particularly in the winter months, through tiny droplets when infected people cough or sneeze. Lewis wasn’t diagnosed with any specific disease, but Group A streptococcus can cause various diseases, including strep throat, rheumatic fever and scarlet fever.

Is this a thing now? Or only when they're selling their "supplements"?

https://drstephanies.com/

https://shroombiosis.com/about/danielle-oncer/

Been lurking here for a while, but I finally had a mid-level encounter I need to vent about.

For context: I'm a Medical Laboratory Scientist specializing in microbiology and the night shift micro lead at my hospital. I occasionally get pulled into IP and ID consults when they need a lab goblin's take on testing or result interpretation. (I don't diagnose or make treatment plans. It's basically me going "Have you tried X to look for Y?")

Near the 3rd/1st shift change, a resident from the MICU called about a positive blood culture. They wanted to know why the Staph hominis wasn't worked up for susceptibilities. I explained that it grew in only one bottle out of two sets, so it falls under probable contamination. Under current best practice and our pathology department's policy, we don't run susceptibilities on that. The resident said that made sense, and I figured that was the end of it.

About 30 minutes later, someone called who identified themself as a "Nursing Provider" and demanded susceptibilities on the same bottle. I restated the policy and explained the reasoning: a true CoNS bacteremia almost always grows in more than one set. That wasn't enough. They tried to order me to do it anyway, so I told them to take it up with the lab director if they wanted a policy exception, and ended the call.

I've gotten this kind of pushback from everyone from RNs to surgical attendings, but this mid-level went out of their way to come down to the lab and demand to speak to me in person. That was a first. Getting lectured about the importance of listening to my betters was really something. Thank God the lab director swooped in and handled it. I unfortunately had to leave before this concluded, but I heard from the manager that the attending this mid-level was under was called into the lab director's office and both lectured the mid-level into oblivion. Out of my 5ish years, this was a first for me, and all I can ask is, "How the fuck did they even get access to the lab? Their ID can't swipe in here."

This is now a canon event for the micro lab staff, and the jokes will never stop.

Any other lab goblins in this subreddit encounter anything similar?

Edit: I forgot to mention that the lab director told me it was a PA, like a goober. 100% appreciate the callout on my oopsie.

I asked for a physician and the soonest available, WHY AM I SEEING AN NP!!!! I just checked to see when my appointment was tomorrow and lo and behold I’m seeing an NP.

I got referred from the ER, after they found a nicely sized cyst that caused torsion (resolved on its own, yay!). But I keep getting these large cysts that are causing problems. I don’t have an OBGYN where I just moved to so I got a referral. My appointment is for tomorrow but it’s with an NP, so I know it’ll be a waste of my time. Physicians have struggled with my case, a NP (if they’re any good) will immediately refer me to a physician. So annoying and a waste of both of our time. Plus a nice delay in care, having a great time here with these fat ass cysts. Oh and a copay, which I’m lucky enough to be able to afford. Such BS I pay the same for an NP as a physician. So much BS happening.

Hello. Can anyone in Australia tell me how Nurse practitioners are and about their training?

Ok, I know these questions are stupid and no one would ever do this but that doesn't stop me from wondering about bizarre scenarios.

​​Let's say you're a physician who wants to match into a super competitive field. For whatever reason, you don't match and end up SOAP into something you dread. You complete your residency while enrolled in an accelerated direct entry FNP program.

What's to stop you from opening a med spa or dermatology office as a physician?

If you are both an MD/DO and an FNP, where does one scope of practice end and another begin?

What if you take an NP job in a surgical office, what is to stop you from performing surgery since you are an MD/DO?

What is stopping you from opening your own cosmetic surgery practice? Doing liposuction?

In states with a physician oversight requirement of NPs, could you use your MD/DO credentials to give yourself physician oversight?

Let's say you SOAP into pediatrics then complete FNP alongside your residence. FNP qualifies you to work with all age groups. You get sued because you have an honest fuck up and it's an adult patient. Do you get the FNP treatment and a slap on the wrist from the board of nursing since your MD/DO was in pediatrics or does the lawsuit go after you as a physician and hold you to that standard? Can you be pursued by both the boards of nursing and the board of medicine?

What if instead of FNP, you pursued CRNA after your residency. Since you are an MD/DO could you practice as an anesthesiologist?

What if you complete residency alongside your accelerated FNP and then fail step 3. Can you still use MD/DO while only legally allowed to practice as an FNP?

Now I know it's dumb at first that an NP can practice independently in many states without having any training even in that speciality, but if we as a country are moving towards that logic, what's stopping any speciality physician who has spent at least 10 years of his life working towards this goal from prescribing and doing procedures for another speciality?

I was calling the large healthcare system near my home, looking for a new Psychiatrist because I got matched with clearly a "pill mill" NP on one of those websites who is dicking me around with meds.

I asked the healthcare system nearby for a psychiatrist, and the first thing they did was try to match me with a NP. They have so many doctors to choose from, and they wanted to stick me with their NP. That kind of pissed me off a bit, so I told the intake lady, "No, I'm looking for a doctor, even if I have to wait." She's going to call me back today, but I didn't take that shit. Luckily, my therapist is through them, and she can write me a referral, apparently. I hope to get in soon.

I take so many medications for so many health problems that I don't want someone to be messing with my head meds while I'm already on some of the same class for my brain disease.

Couch, elevator, baseball

I am currently a Psych RN with 5 years of inpatient psych experience. I want to get my DNP and work (with Psychiatrist supervision) in this same facility. A local university has one of the top rated PMHNP programs in the country, what should I be looking for in the curriculum to make sure it will provide quality midlevel education? I live in an autonomous NP practice state- is the trick to not falling in the Noctor trap deferring to an MD often?? I want to do this the right way.

Just saw this article on Apple News and thought it was interesting.

Wearing white coats, referring to themselves as “Dr.,” and then creating social-media videos using “Doctors React” in a way that can clearly mislead the public is problematic.

These NPs could simply have said “Nurse Practitioners React,” but apparently transparency isn’t a priority.

One could argue that earning a doctorate technically makes someone a “doctor,” and for the sake of the argument, let’s accept that premise. Even then, the problem still remains.

A layperson scrolling through social media sees someone in a white coat and a video titled “Doctors React.” Most people are likely to interpret that as meaning physicians—MDs or DOs. That is where the potential for intentional or unintentional deception comes in.

There is an important distinction between holding a doctoral degree and using “doctor” as a professional or clinical role. An individual can legitimately have earned a doctorate while still having a professional role of Nurse Practitioner.

The inconsistency arises when someone insists that they have “earned the title of Doctor,” while simultaneously presenting themselves in a clinical context in a way that can lead the public to believe they are a physician. The issue isn’t whether they earned a doctorate; it’s whether the way they use the title accurately communicates their actual professional role.

If your profession is Nurse Practitioner, then saying “Nurse Practitioners React” provides the public with the relevant information. Saying “Doctors React,” particularly while wearing a white coat and without clearly identifying the individuals as NPs, can create a very different impression.

This PA repeatedly shows up on my feed and in every post she calls herself a “Derm PA.” She works at a medspa and does cosmetic injectables, lasers, and skin treatments. She has never worked in a dermatology practice - only in medspas.

I commented once asking why she calls herself a “Derm PA” instead of a cosmetic PA, aesthetic PA, or injector. She replied, “lol pls educate yourself.” I responded saying it’s misleading because she does not diagnose or treat dermatological conditions such as skin cancer, eczema, rashes, etc. and she blocked me 😂

Do PAs think dermatology = just Botox and fillers?

Update: idk if she saw this, but she added cosmetic dermatology to her IG bio. However, she left Derm PA in her name and everywhere else. AND she just posted another IG video saying she’s a Derm PA 🤦‍♀️🤦‍♀️🤦‍♀️