Doctor Shortage Dilemma: Using APPs like NPs, PAs & CRNAs always backfires. #446 Part 3 - podcast episode cover

Doctor Shortage Dilemma: Using APPs like NPs, PAs & CRNAs always backfires. #446 Part 3

Feb 17, 202511 minEp. 446
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Episode description

SEND US A TEXT MESSAGE!!! Let Drs. Nii & Renee know what you think about the show!

We tackle the pressing issue of physician shortages and the disconnect between medical school admissions and residency spots. We also discuss why using APPs like Nurse Practitioners (NPs) and Physician Assistants (PAs) in place of physicians does not work in the long run.


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Transcript

Physician Shortage and Healthcare Future

Speaker 1

What's good everyone . This is Dr Nidarko . Make sure you hit the subscribe button below so that you're always up to date on the new uploads as well as alerts on this show . The other thing that you can do to help build this community is make sure you leave a comment below .

Let us know what you like , what you don't like about the show and , ultimately , let us know who's winning these arguments , because I need to know that I'm beating Rene in these debates . Run the tape . So there's a congressman , congressman , greg Murphy .

He put out a tweet and he says the number one reason for MD shortage is med schools admitting students who aren't going to practice . Only 60% of med students today plan on practicing clinical medicine . Med schools need to focus on admitting students who want to take care of patients , not just get their MD .

It should be mandated that , unless disabled , each medical school graduate should have to practice medicine full time for 15 years minimum to refund the federal government for the cost of tuition . Yeah , yeah , but Dr Cooper , dr Cooper , have you ? You've been practicing now , she's been practicing the same amount of years as me and you and stuff .

Speaker 2

So about the same .

Speaker 1

Have you ever thought about , like when you were started , when you started residency or when you finished residency ? Did you ever think about having an expiration date , like maybe like 15 years , 20 years or you know , retiring at , you know in your 50s or something like that ?

I'm very interested because I I just think that more and more people are thinking about that , but I don't know if that's a majority , I don't know Like 30% , saying like yo , because that's crazy , then Right , that's like going to like buying something off of Amazon and it's saying you know , this is returned a lot , right , right .

Speaker 2

Like that's like saying I just want to get their MDs , and it's like for what reason ? Because that is a very expensive endeavor , not to have a means by which you're going to make that back . And we know that the at least most- .

Emily Cooper says 15 years , 15 years , 15 years 15 years , I think we know that the surest way to make that money back is to work clinically , because anything else is a roll of the dice .

Speaker 1

So Dr Cooper says I figured I would practice at least until I retired or moved into the C-suite Then she'd become a white collar worker , then we'd be complaining about her , yeah . You'd be telling us what to do M- . Yeah , you'd be telling us what to do . Ml , you'd be telling us what to do ?

Speaker 2

ML , absolutely , absolutely .

Speaker 1

I just think that you know things change , it's not like how it was . When you know this is not the 70s , this is not the 80s , yeah , Not the 90s , a couple of things . When you know this is not the seventies , this is not the eighties , not the nineties , a couple of things . One you know corporatization of healthcare , it all it does .

For the most part it squeezes the practitioner like crazy do more with less . And then also , on the other hand , now with the internet , you just got a lot more things that you can do with your MD or DO , just got a lot more things that you can do with your MD or DO , yes , right .

So people want experts on TV , people want experts on YouTube , podcasts , right . Pharmaceutical companies want the expertise of what you can do . So there's just the pasture . Like it's not the pasture but like the grass is green on a lot of different aspects of healthcare . So people realize that , look , I just don't want to just practice clinically .

Yeah , you try to fit like a square peg , you know , in a round hole and stuff . It just doesn't work for everybody . But I think part of it , the big issue and the physician shortage , really doesn't have anything to do with physician satisfaction . I think most people would say the physician shortage is yo .

First of all , med schools don't admit as many people as they should be . And I'll just say this hot take I think it should be harder to get out of medical school than it is to get into medical school , right , right . So what I mean by that is you don't necessarily have to be so hard to get into medical school .

It should be hard to get into medical school , but I think they should increase the amount of people that they're letting in . Where it becomes super difficult , or where it should be really difficult , is for you to get out of medical school because you have to show all these different things , these different you know rigors to get out .

But you know , I think , that if you have these situations where one it's very hard to get in , you have these medical school classes that are putting out small amounts of people .

Then you have residencies that just there's not many residencies out there , outside primary care , outside of you got an issue like , for example , pediatric surgery For decades , you know , the numbers have just increased just the smidgen , you know , and it doesn't keep up with how we are in society .

Speaker 2

Considering he's in Congress . I mean , one of the things that he doesn't necessarily tweet about at least that I haven't seen is that there isn't quite , you know , the number of residency spots , as there should be , in comparison to the number of medical schools that are opening up and producing more and more medical graduates . That's the bottleneck .

That's the bottleneck . You have a lot more medical schools that are opening up , Exactly so . Therefore , these people cannot be trained .

Speaker 1

The residency spots have stayed the same .

Speaker 2

Exactly , these people cannot be trained .

You have all these medical schools , either , increasing their class sizes , the ones that you know , medical schools that have already existed , for you know by all the powers that be , including the federal government , who gives these , you know who gives loans to these students and essentially , the medical schools are ensuring that there are plenty of graduates , but the

residency programs are not ensuring that there are plenty of trainees , and that's a Congress problem .

Speaker 1

I can't even get down with him saying that , yeah , we're going to try to minimize , we're going to try to make sure that med schools can't increase their tuition crazily every year . If he said something like that , I'd be like all right , Good luck with that .

Speaker 2

That makes no sense to me .

Speaker 1

Anyway , good luck with that , because you should wrap this up , though we need to wrap this up . Yeah , guys , we're going to be talking about this on episode of docs outside the box . You can find us on YouTube at docs outside the box podcast . We're also on all DSPs .

We're also on all DSPs any place where you listen to your favorite music and album , any place where you listen to your favorite podcast , just type in Docs Outside the Box . That's where you'll find us . And someone says perhaps their agenda to utilize APPs beyond their scope because they're cheaper Absolutely , absolutely , 100% .

But here's where I think that backfires , right ? So I think , yes , you know , apps and nurse practitioners end up being cheaper than a physician , right ? Apps don't follow a Hippocratic Oath , right ?

Speaker 2

I mean , does the old really matter at this point ? There's so many doctors out there .

Speaker 1

I'm not saying like , I'm not talking about degradation or anything like that , but like , if you really want , if you're worried about doctors like striking , like APPs , and nurse practitioners that , for the most part , have no problem being employed , the likelihood of them striking , the likelihood of them , oh , it's very high , it's extremely high .

It's extremely high , it's extremely high . To walk away is a lot easier than a physician . Think about it , right ?

Speaker 2

That's the part that I'm like . Yeah , I don't think about that . A lot of the APPs right , a lot of the APPs used to be RNs . What do we know about RNs ? Rns being , yes , because nurse practitioners .

Speaker 1

You said a lot of APPs . Yes , because nurse practitioners . You said a lot of AP . Oh so , and first right advanced . You talk about APPs and CRNPs .

Speaker 2

No , when he says AP , when or he or she says APPs , we're talking about advanced practice partners or advanced , basically advanced people .

Speaker 1

So you're talking about PAs and nurses .

Speaker 2

Yeah , pas , nurse practitioners , crnas right .

Speaker 1

They used to be nurses .

Speaker 2

Many of them used to be nurses right , especially the CRNAs and the MPs . They used to be nurses right . And what we know about nurses is they be striking . They have unions . Nurses be striking all the time . Nurses will not hesitate to strike you hands , nurses be striking all the time . Nurses will not hesitate to strike . They'll be like I don't care .

Who going into the pictures is not going to be me today , okay . I don't know who going to be calling the doctor and telling them about this patient coding is not going to be me today , okay . So nurses are very used to striking .

So when they become NPs or CRNAs listen that feeling or that tendency might they're not considered people who can unionize who , crnas and nurse practitioners ? Why not ?

I said I don't know , because there's like some fine line between management and not management and blah , blah , blah , right , yeah , advanced practice providers that's what it is , that word providers always throws me off .

Speaker 1

I think it's easier , I think it'd be easier you know what APPs to unionize than doctors . Oh , of course , I think that it'd be the level .

Speaker 2

But I wonder how many APP .

Speaker 1

Although the barriers there are the barriers to unionize with doctors has been lowering , yeah , you know considerably year by year

Healthcare Podcast Discussion

. So yeah , hey guys , check us out on docs outside the box podcast . You can check us out on YouTube and we're also here . Yeah , I know .

Speaker 2

You know why I don't really be using that word providers like that .

Speaker 1

So so on the podcast , we get an opportunity to talk about this stuff more , flush it out . We ask more questions , we just it's a lot . It's a lot easier for us to have these discussions on the podcast . So if you want to know more about us and our thoughts on things specific like this , check out our podcast .

Speaker 2

That's outside the box .

Speaker 1

I appreciate everybody jumping in on us . We might do this again very soon actually , so stay tuned . All right , peace y'all All right , and I'm new to this , so should I hit X right ?

Speaker 2

now you go hit the X button , bye .

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