How does one properly place a social media consult? If this post by acute care NP Jessica Jenkins Smith is any indication, it's by posting a screenshot of a patient's X-ray to a Facebook group with no clinical history or context whatsoever and asking for another midlevel nurse practitioner who will likely be equally mystified. Maybe...just maybe...it would be better to consult a physician who specializes in reading and interpreting imaging studies. Wait a minute...isn't there a term for that? Radio something?Rad...rad...radiology...radiologist, that's it! Maybe we should ask a radiologist what might be going on here? That's exactly what we did! After consulting our on-call MidlevelWTF radiologist (who snarkily remarked " I wouldn’t even put this on boards - it's too easy"), we've come to the conclusion that this plain film very likely shows a case of Osgood–Schlatter disease.
Treatment for Osgood-Schlatter disease in most cases is conservative with rest, ice and over-the-counter pain medication, and to be quite honest this is first/second-year medical student-level stuff, let alone something that virtually any intern would quickly recognize. This is the kind of basic medical knowledge that gets beat into young doctors' brains with the pointy part of the tibial tuberosity. One would think that someone who has been working as an NP for several years would recognize this, but apparently not. We wonder, do they cover these sorts of no-brainer things at the perennial star favorite of 100%-online, for-profit NP diploma mills, Walden University? Let's take a look at the Walden Adult-Gerontology Acute Care Nurse Practitioner MSN curriculum:
Hmm, which class do they cover the skeletal system in? Is it in "Essentials of Evidence-Based Practice"? Or perhaps in "Advanced Health Assessment and Diagnostic Reasoning"? Apparently, the latter covers "the advanced skills of suturing, reading 12 Lead EKGs, and interpreting X-rays." We're not really sure how those three things are at all related, or even advanced; there's nothing "advanced" about recognizing a common pathology on an X-ray that a radiologist could interpret with his/her eyes closed, or about being able to suture and read EKGs. That's like How To Be A Fucking Doctor 101.
As the old English adage goes, a picture is worth a thousand words, and it's truly remarkable how a relatively simple X-ray can go so far in demonstrating the educational inadequacy and medical incompetency of midlevel nurse practitioners. Hopefully, this patient didn't get sent to the vascular surgery NP for a leg amputation!