Thread by @Suburbanbella

Tweet Peeps, most of you who know me know that I am a wordsmith. Not quite as exceptional as @OTirmizi, but close. One of my biggest pet peeves is word manipulation. Spinning. Why? Because in some instances, it is intentionally used to deceive. When it deceives the public, I get

2)enraged. So let me demonstrate an example of a hospital's ad to provide consult services for Endocrinology, specifically, diabetes. So the "specialists" in the ad are two NPs. Deceitful act #1: One NP is described as a "board-certified NP who specializes in care for

2)endocrine diseases..." The implication is that he/she is a specialist in diseases of the endocrine system, with a particular focus in DM. His/her memberships includes the American Association of Clinical Endocrinologists(-ology)--lending false credibility to his/her being an

3)endocrine specialist. The second individual is an Adult Geriatric NP, also with a special interest in DM. At the end of their alphabet soup are acronyms indicating they are certified in DM education and/or management. Not endocrine--DM. Deceitful act #2: It is not clear here,

4)but NP subspecialties such as endocrine do not require schooling, just "training". OJT. A NP who works with an endocrinologist for 2 months may arbitrarily refer to him or herself as an "Endocrinology NP". They are actually NPs who work in endocrinology. Big difference in

5)meaning. That's the spin. It conveys an expertise that is not comparable to a physician who specializes in Endocrinology. For example, Duke has an endocrinology specialty for NPs--it's three courses in addition to their NP specialty/focus. Online, except for one day where they

6)must go on campus to have hands-on training/simulation of insulin pumps and Glucose monitors. Compare that to an endocrinologist who must have prior training in IM(3 yrs), Peds(4yrs) or Ob/Gyn(4yrs) before completing a 2 year fellowship in endocrinology. Duke is a stellar

7)school. Unfortunately, like a few other Ivy League or big name schools, they have joined the online NP degree mill racket. Their NP program is well structured. However, there is no way you can convince me that someone can become an expert in a medical specialty that requires

8)total immersion in a hands-on, didactic and clinical educational program. The majority of NPs in endocrine will most likely have trained under an endocrinologist who then determined, arbitrarily, that the NP was competent to see patients as initial consults. Despite the fact

9)that a fully trained and licensed physician referred patients to an endocrinologist for further assessment. It is safe to assume that the referring doc is most likely medically competent, has evaluated/treated/managed, etc. the patient and has hit a block in which more

10)expertise is required, only to have their patient seen by a NP who is not trained in medicine nor is an expert in endocrinology. The old bait and switch. Deceitful act #3: When a doctor vouches that a NP is an expert in his specialty because the NP was trained by him/her,

11)he/she is lying to the public. What do mosts specialists know about NP "specialties" or "subspecialties?" and their actual training? Again, a physician is not a nurse so when training, he/she is training in a medical model, the only model they know. NPs have no foundation in

12)medicine since they did not attend med school. What fundamental knowledge base is the physician then building on? A nursing foundation, something they know nothing about unless they have themselves previously been a nurse or NP. In the screenshot, the ad indicates the NPs can

13)provide consults for critically ill inpatients with DKA and HHS. That is worrisome. These NPs may be perfectly qualified to manage stable patients with DM and provide diabetes education. However, they are not physicians and should not be permitted to perform initial consults

14)on critically ill patients. Were I a patient reading this ad, I would feel perfectly secure. Ignorant of the fact that the ad does not indicate any of the information I shared above. So what would be my natural assumption? That they are as good as the doc. When I think of the

15)unmatched doctors who would be much safer to use in this scenario(as consults) but can't because they are not considered to have enough knowledge...Well--I get incensed. Please push your legislators to support this bill:
@pppforpatients @AmerMedicalAssn @acgme @AAMCtoday

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