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Every once in a while, I see medical decision making in the sub-MD medical community be so astoundingly bad that I could scream.

Just because it’s cheaper to see a physician substitute doesn’t means it’s better.

That said, I’m all for not wasting money on healthcare. And as most people do not require nor receive actual medical care, spending the least amount possible on this makes total sense. I do not agree with lawfare being used to prevent individual access to commonly prescribed medications either … and thus I am pro physician extenders because at least it is cheaper.

But sometimes some people do require actual medical care. These people are poorly served by profit maximizing cost minimizing para-professionals.

IMHO, go ahead and see your NP for stuff that doesn’t matter. But if the problem is not solved in short order, see a physician.

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Discussion

scrolls of ancient wisdom 6mo ago

I can't find competent physicians where I live so have to do my own care which I really don't like

Dr. Bitcoin, MD 6mo ago

Not uncommon.

That said, as a physician, the only thing I’ve needed a physician for in the last 35 years has been antibiotics and eyeglasses and laboratory screening. Absolutely zero of this care truly required a physician…any idiot with a prescription pad or a trip to Mexico to take advantage of Mexican law would have sufficed perfectly in lieu of so called “medical” care.

Wonteet Zebugs 6mo ago

It's hard to find physicians who knew not to take the death jabs.

If they took them, it pretty much invalidates their opinions, except for very specific things (local surgeries, etc).

Dr. Bitcoin, MD 6mo ago

Meh. Most of that turned out to be meaningless for the overwhelming majority of people.

That said, recommending jabs was based on too thin of evidence.

Wonteet Zebugs 6mo ago

Excess mortality went way up. Lots of people died because of that (not to mention the harmed but not killed). I wouldn't call it meaningless.

https://ourworldindata.org/grapher/excess-mortality-p-scores-average-baseline

Dr. Bitcoin, MD 6mo ago

Who called it meaningless? But the fact remains that most people were neither helped nor harmed. Hence it is meaningless to most people. That doesn’t equate with meaningless to all people.

Shawn 6mo ago

I switched to a direct primary care doc last Fall. It was the only path forward for me. Tragically, doctors in America, broadly spreaking, have failed. Bad incentives, bad practices, captured entirely by insurance and pharma.

The upside: the chaff is easier to spot, and the wheat will stand apart.

Dr. Bitcoin, MD 6mo ago

I hope and wish this will become more true more broadly as time goes on.

A lot of medicine is a scam, but largely because people believe they are entitled to care at any cost as long as someone else is paying.

And most scammy care providers will go many years telling everyone they’re fine if they’re under age 50 and massively over testing everyone else and never be “wrong.”

Real medicine is about being right when it matters and not taking action when you can’t help. It’s 2% the former and 98% the latter. I’d argue it’s the 2% that really qualifies as medicine; the other 98% is nonsense, much of which unjustly creates an income stream for healthcare providers by placing certain medications behind a prescription paywall.