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Obnoxious!!!

 

The Florida Pill mill issue (80% of WORLD WIDE OXYCODONE for a few years) was SOLELY Doc's (PA and NP could not prescribe then)

 

Where was this doc then?  

 

 

It is embarrassing for a doc to stoop to such level - we all have stories and tall tales of horrible providers, PA, NP, MD DO - and we ALL (including this doc) should be smart enough to rely on evidence....  not of a single provider but of a profession.  

 

If anything I think that the boards of medicine have done a very poor job of controlling their own, heck if the Florida board had one functioning brain cell during the opioid crisis they would have gone after the pill mills.  Instead it too threats from national law enforcement agencies, and years later for them to FINALLY start to go after the doc's    heck in my little town there is a doc that has lost his license twice (no records, and allegedly trading scheduled drug scripts) and has both times gotten it back.  If this was a PA or NP the board would have crucified us.  I would propose the truth might be opposite what this bone head says.....

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4 minutes ago, ventana said:

Obnoxious!!!

 

The Florida Pill mill issue (80% of WORLD WIDE OXYCODONE for a few years) was SOLELY Doc's (PA and NP could not prescribe then)

 

Where was this doc then?  

 

 

It is embarrassing for a doc to stoop to such level - we all have stories and tall tales of horrible providers, PA, NP, MD DO - and we ALL (including this doc) should be smart enough to rely on evidence....  not of a single provider but of a profession.  

 

If anything I think that the boards of medicine have done a very poor job of controlling their own, heck if the Florida board had one functioning brain cell during the opioid crisis they would have gone after the pill mills.  Instead it too threats from national law enforcement agencies, and years later for them to FINALLY start to go after the doc's    heck in my little town there is a doc that has lost his license twice (no records, and allegedly trading scheduled drug scripts) and has both times gotten it back.  If this was a PA or NP the board would have crucified us.  I would propose the truth might be opposite what this bone head says.....

Medical boards protect physicians, nursing boards protect nurses. Unless NP happen to be regulated by medical board, they get by with issues that should cause loss of license just like physicians. PA’s don’t have a chance as medical board will not likely let them get by with any similar behavior(not saying anyone should keep license under those circumstances.

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Ventana, you ask where was this doc when Florida had issues.  Wasn’t it a Texas doc? So question should be where were Florida docs? Unfortunately, protecting a peer professional for inappropriate work ethics or flat out damaging behavior is not unique to Docs or nurses, you can find it in every group, professionally, socially and religious. Protect your own, not those that could be harmed😞

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I'm just appalled at the amount of crappy medicine/advanced nursing that happens and or is tolerated by various regulatory agencies. Pointing fingers is frowned upon within peer groups, but when someone is harmed or killed there's a lot of hand wringing and commentary about how could this or this shouldn't have happened!  What truly ticks me off is to hear about "I knew that he or she was going to hurt someone" when news of a poor outcome breaks. I don't understand the tolerance level for poor care and harmful conduct by providers of all professions?

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2 hours ago, Hope2PA said:

Medical boards protect physicians, nursing boards protect nurses. Unless NP happen to be regulated by medical board, they get by with issues that should cause loss of license just like physicians. PA’s don’t have a chance as medical board will not likely let them get by with any similar behavior(not saying anyone should keep license under those circumstances.

Uhhhhhh.... BONs are well known for seeing their role as protecting the public from poor performing nurses. You have them mistaken for BOMs, who are there to protect the physicians. The physician community has more collegial familiarity with each other than probably any other profession. You’ll rarely see one of them throw another under the bus. It’s as “good old boys” as it gets. They all went through the same crucible of medical school and residency, and have the same shared experience in their eyes. They may trash each other to each other, but they will fight like lions to keep any member of their craft from losing out on the >10 years of training that each other put into their work. No physician wants karma to come around and yank their own licenses someday. 

 Nurses eat their own. Plus, an NP could be sitting in front of a disciplinary board consisting of mostly RNs. Sorry, never got the impression that the BON was extending warm fuzzies to NPs with their certified letters. I don’t know many NPs that would get by with having sexual relations with patients, let alone adolescent ones, but heck if physicians don’t. “Action plan?: chaperone!”

Meanwhile, the BON will nail you down with a disciplinary action over some meager stuff.

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9 hours ago, Lightspeed said:

Uhhhhhh.... BONs are well known for seeing their role as protecting the public from poor performing nurses. You have them mistaken for BOMs, who are there to protect the physicians. The physician community has more collegial familiarity with each other than probably any other profession. You’ll rarely see one of them throw another under the bus. It’s as “good old boys” as it gets. They all went through the same crucible of medical school and residency, and have the same shared experience in their eyes. They may trash each other to each other, but they will fight like lions to keep any member of their craft from losing out on the >10 years of training that each other put into their work. No physician wants karma to come around and yank their own licenses someday. 

 Nurses eat their own. Plus, an NP could be sitting in front of a disciplinary board consisting of mostly RNs. Sorry, never got the impression that the BON was extending warm fuzzies to NPs with their certified letters. I don’t know many NPs that would get by with having sexual relations with patients, let alone adolescent ones, but heck if physicians don’t. “Action plan?: chaperone!”

Meanwhile, the BON will nail you down with a disciplinary action over some meager stuff.

With appropriate research, I’d put my money on physicians NOT being appropriately represented at a higher rate than nursing, or anyone else for that matter. However, look at Tenn, NP one of top over prescribing meds , also in Dec 2018 there was a report out of Washington DC Public citizen stating that nursing board are failing to report issues that harm patients. I just had the annual Privacy talk at my hospital. The person in charge of compliance and privacy, as common in most facilities, is a nurse.  She gave two examples of hospital employees posting comments on Facebook. Comment #1 (a transport aid)was general remark about all the drug overdose patients coming to ER. Comment #2 (an RN) was about an elderly patient in a specific ward, with a specific illness. The transport aid was fired, the RN was told to remove post. The privacy (RN) director stated she was the one to decide to take higher, and she felt the comment about drugs was malicious and the other was not. . RNs care about patients and she wasn’t meaning or posting anything bad. Although went on to tell us all that we are NEVER to post anything about the hospital and patients or we can definitely lose our jobs! 

I know this is minor, but again, protect their own...

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2 hours ago, Hope2PA said:

With appropriate research, I’d put my money on physicians NOT being appropriately represented at a higher rate than nursing, or anyone else for that matter. However, look at Tenn, NP one of top over prescribing meds , also in Dec 2018 there was a report out of Washington DC Public citizen stating that nursing board are failing to report issues that harm patients. I just had the annual Privacy talk at my hospital. The person in charge of compliance and privacy, as common in most facilities, is a nurse.  She gave two examples of hospital employees posting comments on Facebook. Comment #1 (a transport aid)was general remark about all the drug overdose patients coming to ER. Comment #2 (an RN) was about an elderly patient in a specific ward, with a specific illness. The transport aid was fired, the RN was told to remove post. The privacy (RN) director stated she was the one to decide to take higher, and she felt the comment about drugs was malicious and the other was not. . RNs care about patients and she wasn’t meaning or posting anything bad. Although went on to tell us all that we are NEVER to post anything about the hospital and patients or we can definitely lose our jobs! 

I know this is minor, but again, protect their own...

The director was right. Just on the surface from what you said, one comment demonstrated a liability to the image of the hospital and criticized the clientele, and the other was a privacy breach. Most folks who get fired for a social media screw up are canned under the notion that they bring bad press to the facility. Both are bad, but one brings a lot more heat to the facility. My guess is that had the posts been reversed, the reverse would have been true. Can’t have a nurse working that public ally expressed disdain for the patients, or paints the facility as a dumping ground for addicts. One remark damages the hospital image, the other may or may not expose private patient information to someone who then has to do extensive detective work to figure out who the exposed patient is. 

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4 hours ago, PAinPenna said:

I will never get my head around how NPs are licensed to practice medicine by a nursing board.  

They get to do it because nobody on a medical board has been to NP school, understands the role, or practices under their scope of practice every day like other nurses do. People should be represented and overseen by people who know their role most intimately. Yes, physicians are top of the food chain about the overall practice of medicine, but the functioning of a board of conduct is about how well an adherent complies with their place within the limits that are circumscribed by the role. Who better to do that than someone else who hopefully has insight into meeting those requirements? That’s why the ANA gauges the onerousness of state practice law with one of its categories for a favorable practice state being whether the BON supervises NPs, or if it’s an offshoot of the BOM. If I had my way, I’d even limit the number of mere RNs on BON actions that affect NPs. 

Incidentally, I’d favor PAs being able to police PAs. It’s not about judging whether NP or PA practice matches that of physicians when you are dealing with board actions, it’s about whether an individual’s conduct meets the standard of the profession. Under current conditions where PAs are supervised by physicians on boards of conduct, it’s a lot like having race car drivers supervise and judge taxi cab operators regarding driving performance. Some may argue that the correct comparison would be to say physicians are experienced taxi cab drivers and PAs are new drivers within the analogy... but realistically, you guys will never be able to obtain “experienced” taxi driver status by virtue of additional years of experience, so that point would be moot. I’m also not saying there isn’t a role on a board for citizen representation, or a physician here or there, but I want to be judged by a jury of my peers, not by one with paternalistic tendencies. I think that the PA and NP careers are both mature enough to be able to handle something that, say, a board of CNAs might not be, so obviously there would be a limit to the extent by which my logic would prevail on all levels of professional hierarchy. 

One more thing... the NP board probably isn’t the last stop for NP accountability. Board of pharmacy and the DEA have a role to play too. The physician in the news that I was thinking of that I cited earlier faced sanctions from both his state’s medical board and board of pharmacy. A provider without prescribing privileges is about as useful as a whale without a tail, so if an offense wanders into the realm of drug provision, then that’s another way to clip provider wings. 

Poor oversight on a board can be rectified by bad press and accountability to political scrutiny. My state is among the vast many who allow NP oversight by BON, and it works very well. Conversely, nothing in the municipality of Washington DC seems to work well, by virtue of the messed up state of affairs that prevail in that city’s government, so it’s no surprise that they have a problem with self governance in the case of their nursing board. I bet all their boards of governance barely pass muster under close examination.

Edited by Lightspeed
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22 hours ago, Lightspeed said:

The director was right. Just on the surface from what you said, one comment demonstrated a liability to the image of the hospital and criticized the clientele, and the other was a privacy breach. Most folks who get fired for a social media screw up are canned under the notion that they bring bad press to the facility. Both are bad, but one brings a lot more heat to the facility. My guess is that had the posts been reversed, the reverse would have been true. Can’t have a nurse working that public ally expressed disdain for the patients, or paints the facility as a dumping ground for addicts. One remark damages the hospital image, the other may or may not expose private patient information to someone who then has to do extensive detective work to figure out who the exposed patient is. 

The RN privacy officer, my mistake in saying director. I understand your point, but the way PO related, neither provided hospital name, both were brought up to her attention because someone knew they were employees and policy is to not post or discuss patients at all, whether good, bad or ugly! I’m sure part of my frustration and feeling that she protects her own was the way she commented on that one example and other privacy issues like talking about patients in elevator, at nurse station etc. She said that when she reviews concerns, she knows as a nurse, they enter field to help not harm and if they did something, in appropriate, it wouldn’t be intended as malicious, plus we need to keep our nurses. In all examples she gave, not one nurse was reprimanded. In all examples, other folks, mostly aids, were.

if it were an RT, PT, PA in the position, they would likely be biased to their group. Point is, more nurses in management and more biased toward their own.  

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4 hours ago, Boatswain2PA said:

Meanwhile nobody on the BON knows how to practice medicine.

That’s the concise and witty reply, but it still ignores everything I said....

Disciplinary oversight should be performed by individuals who are intimately acquainted with the rules, bylaws, and functioning of the role. You didn’t address any of that, you just regurgitated the easiest response that anyone could come up with. And that’s fine. You’d be satisfied being forever supervised by physicians, because you don’t believe in PA independence. You like that net below you. Makes you feel safe. Or maybe you’ll insist that it makes the patients safe.... or whatever rote argument you prefer. Keep preaching it and I’ll keep practicing as an independent provider who extolls the virtues of that status to your peers who seem to get it that your industry should evolve to survive. Sad thing is that I have more faith in your profession than you do. 

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4 hours ago, Hope2PA said:

The RN privacy officer, my mistake in saying director. I understand your point, but the way PO related, neither provided hospital name, both were brought up to her attention because someone knew they were employees and policy is to not post or discuss patients at all, whether good, bad or ugly! I’m sure part of my frustration and feeling that she protects her own was the way she commented on that one example and other privacy issues like talking about patients in elevator, at nurse station etc. She said that when she reviews concerns, she knows as a nurse, they enter field to help not harm and if they did something, in appropriate, it wouldn’t be intended as malicious, plus we need to keep our nurses. In all examples she gave, not one nurse was reprimanded. In all examples, other folks, mostly aids, were.

if it were an RT, PT, PA in the position, they would likely be biased to their group. Point is, more nurses in management and more biased toward their own.  

It’s hard to hit a target when the target keeps moving, so I don’t know how to address my impression of your story now that you’ve updated it. All I can say is that an RT, PT, or PA would or should probably also fall under her definition of people who also enter the field to help and not hurt, and maybe it’s your bias that is getting in the way of feeling like she would give you guys a fair shake.... who knows. In my own experience from what I saw when I was a nurse, playing fast and loose with information wouldn’t go “unrepremanded”, and being chatted with about those kinds of things also came with the implied threat that a license violation could be a possibility. I don’t know the variables. My guess isn’t that you don’t either. Or maybe the nurse leader you mentioned is a glutton for punishment, and feels ok about the possibility of a PT or PA suing her for treating employees in a discriminatory manner. Also, if you think supply and demand doesn’t factor into decisions like that on a regular basis, you need to get out more. It shouldn’t.... but it does, and it works for you guys too.  

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On 9/21/2019 at 9:34 PM, Lightspeed said:

Uhhhhhh.... BONs are well known for seeing their role as protecting the public from poor performing nurses. You have them mistaken for BOMs, who are there to protect the physicians. The physician community has more collegial familiarity with each other than probably any other profession. You’ll rarely see one of them throw another under the bus. It’s as “good old boys” as it gets. They all went through the same crucible of medical school and residency, and have the same shared experience in their eyes. They may trash each other to each other, but they will fight like lions to keep any member of their craft from losing out on the >10 years of training that each other put into their work. No physician wants karma to come around and yank their own licenses someday. 

 Nurses eat their own. Plus, an NP could be sitting in front of a disciplinary board consisting of mostly RNs. Sorry, never got the impression that the BON was extending warm fuzzies to NPs with their certified letters. I don’t know many NPs that would get by with having sexual relations with patients, let alone adolescent ones, but heck if physicians don’t. “Action plan?: chaperone!”

Meanwhile, the BON will nail you down with a disciplinary action over some meager stuff.

ALL licensing agencies’ primary function is to protect the public, not their licensees.  I’m sure you can relate anecdotal stories of medical boards protecting physicians over patients, but anyone else can easily counter with stories of BON’s protecting NPs and nurses- because it’s all anecdotal.  This story shows how much damage one NP was doing to patients, and the BON turned a blind eye for too long.  Boards of nursing do not get a pass in being altruistic more than other licensing boards- whether PA, dental, veterinary, physical therapy, optometry or otherwise.

BTW- the group “Physicians for Patient Protection” are a special interest organization who believe only physicians should practice medicine

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1 hour ago, True Anomaly said:

ALL licensing agencies’ primary function is to protect the public, not their licensees.  I’m sure you can relate anecdotal stories of medical boards protecting physicians over patients, but anyone else can easily counter with stories of BON’s protecting NPs and nurses- because it’s all anecdotal.  This story shows how much damage one NP was doing to patients, and the BON turned a blind eye for too long.  Boards of nursing do not get a pass in being altruistic more than other licensing boards- whether PA, dental, veterinary, physical therapy, optometry or otherwise.

BTW- the group “Physicians for Patient Protection” are a special interest organization who believe only physicians should practice medicine

Yep. That was my point when I countered someone else’s initial anecdotal story. Thanks for agreeing with me. 

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6 hours ago, True Anomaly said:

My point is that medical boards are also there to protect the public primarily, not physicians first

The road to hell is paved with good intentions. Having read the Medical Board actions over the years I am amazed at just how few licences are  suspended or revoked by the board. Stated mission versus actual activity,

?

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