The title Doctor is increasingly being used by many healthcare professionals. Physicians (MDs and DOs), nurse practitioners (NPs), physician assistants (PAs), pharmacists, physical therapists, psychologists, and others might hold doctoral degrees. All of these care providers carry very different levels and types of training and experience. With NPs becoming more common, it's important to know the distinction between a Nurse, and Physician. Some clinics or hospitals don’t clearly differentiate the roles unless you really read the fine print—or ask directly. The out of pocket cost is the same, but the quality of care can be very different.
Working with a physician instead of a nurse may be necessary in certain situations due to the differences in their training and expertise. Physicians are required to accrue over 10,000 hours of supervised training in residency, prior to practicing independently. Nurse Practitioners are only required to have 500 hours, and simply shadowing (not supervised patient care) can qualify.
For most care situations, it's been found that most insurances reimburse NPs at 80% of the physician rate, despite NPs only having 5% of the training, and costing the patient the same amount of money as seeing a physician. Credentialing requirements mandate NPs to have only 5% of the supervised training hours that physicians need to have.
Both 30-day mortality rate and mortality rate after complications (failure-to-rescue) were lower when anesthesiologists (physicians) directed anesthesia care as compared to nurse led care.
Factors independently increasing the risk for unexpected disposition included procedures performed in hospital-based versus freestanding facilities [odds ratio (OR) 6.83 (95% confidence interval [CI] 4.34; 10.75)], shoulder versus knee procedures [OR 3.84 (CI 2.55; 5.77)], anesthesia provided by non-anesthesiology (non-physician) professionals and certified registered nurse-anesthetists versus anesthesiologists [OR 7.33 (CI 4.18; 12.84) and OR 1.80 (CI 1.09; 2.99), respectively].
In 2020, 3.8% of MDs, 8.0% of NPs, and 9.8% of PAs met at least one definition of overprescribing opioids. NPs/PAs practicing in states with independent prescription authority were > 20 times more likely to overprescribe opioids than NPs/PAs than in other states.
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