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NPs in the ED, Was This a Fair Study?


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I didn't download the actual paper but I'd be interested in looking at the actual data. The NPER summary did mention there was variability within the professions themselves. 

"Overall, the study shows that NPs increase the cost of ED care by 7%, or about $66 per patient. Increasing the number of NPs on duty to decrease wait times raised total health care spending by 15%, or $238 per case—not including the cost of additional NP salaries. In all, assigning 25% of emergency cases to NPs results in net costs of $74 million annually for the VHA."

So are they suggesting to just put that money towards hiring more physicians instead? Or are they suggesting that they should stop staffing the ED with extra personnel (NPs) and stick to the physicians they have to keep healthcare spending low despite increased wait times? It'd be interesting to see a f/u paper studying the outcomes with these increased wait times and physician-only ED care.

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You can have an agenda and it still be legit.

A better test is the simple sniff test:  Does it make sense.  Sooooo many "studies" are so selectively chosen, and so full of bullexcrement, that they just just defy common sense. 

So, let's apply some common sense here and see if the study passes the sniff test.

1. The baseline NP is poorly trained compared to a PA, and VASTLY undertrained compared to physicians.  More time looking stuff up, inappropriate ordering and interpretation, and longer discharge times would be expected.


2. Even "good" NPs (and PAs) consider "protecting their doc" on patients they see, which by itself likely increases testing.

So yeah, findings don't surprise me.

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