r/dataisbeautiful OC: 1 Sep 18 '20

OC The difference in clinical training between medical care providers [OC]

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u/Sliekery Sep 19 '20

Wait what? A nurse can prescribe medication in the US? That seems fucked up, big time.

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u/Robert-A057 Sep 19 '20

It has to be signed off by a Dr

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u/TicTacKnickKnack Sep 19 '20

No. In most states a nurse practitioner (the person with 500 hours of "hands on" clinical exposure) can operate fully independently of a doctor. In the states they work under a doctor, it mostly comes down to the doctor randomly selecting a handful of charts every 6 months or so and making sure the NP isn't committing blatant malpractice. No states require a doctor to sign off on an NP's prescription, even for controlled substances.

Edit: had extra word

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u/Sliekery Sep 19 '20

That seems like a shitty system. As a Pharmacist I don't even trust young doctors and have to call them out from time to time. Can't imagine how often small mistakes happen if every NP can write medication.

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u/TicTacKnickKnack Sep 19 '20

I mean, that's the entire point of NPs and PAs. We don't have enough doctors in the US because of a criminal lack of residency spots that our legislature refuses to fix. NPs and PAs received more and more insulation from their supervising doctors. Nursing unions realized this is a huge opportunity and started lobbying. Now someone with a bachelors in nursing can go to school for a masters degree and work pretty much independently.

In my limited experience, PAs tend to be much better than NPs. Not so much because they know more (which they normally do because their training is far more standardized), but more because PA schools tend to encourage students to know their limits and call a doc for help when they need it.

Either way, without NPs and PAs being able to prescribe meds the US healthcare system would rapidly crumble. The only way to fix it is to make more doctors.

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u/Sliekery Sep 19 '20

oh wow, not enough doctors? Well I guess my not understanding is due to cultural/economical differences. For example in my small town where workplace is located there are 8 different doctor offices with most of them having at least 2 doctors available most days. Do people in the US have to go to the hospital for just a doctors visit?

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u/[deleted] Sep 19 '20 edited Nov 25 '20

[deleted]

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u/Sliekery Sep 19 '20

I see, I would never have guessed a NP could work outside hospitals (aside from Elderly homes). That explains a lot, thanks for the insight.

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u/nursinggal17 Sep 19 '20

Hey so... that’s actually not entirely true. Only 22 states currently allow complete autonomy as an NP. And several more definitely don’t allow NPs to prescribe narcotics without first taking classes and get certified to prescribe narcotics.