We tend to see quite a few examples of midlevel nurse practitioners (especially the more militant ones) claiming that their knowledge and experience is equivalent to, or surpasses that of a physician (LOL), usually without any evidence to back up such an ambitious claim. They then proceed to do some hand-waving and cite this is a reason why they should be allowed to practice independently, without any physician supervision. So let's have them put their money where their mouth is, shall we?

Here we have an example "clinical pearl" about meningitis from one of the various Facebook "study groups" for nurse practitioners preparing for exams. From a physician's (or even a second-year medical student's) perspective, everything on this slide reads like "no fucking shit!" The information on this slide is so vague as to be almost useless in a clinical setting, which is ironic, because we all know midlevels like to brag about their "superior" clinical skills as a selling point. There's absolutely no specifics about the pathophysiology of meningitis, what pathogens typically cause it, which pathogens are more common in a given age range, what the diagnosis and workup for meningitis is, and what the actual management/treatment for it is. I could go on and on. Like, duh, I could've told you meningitis is potentially life-threatening well before I went to medical school. Urgent antibiotic treatment? What antibiotics, exactly? When do you give them? Oh, and what about prophylaxis about close contacts, and what kind of prophylaxis and for how long? For the laypeople out there, here's an example of what meningitis "watered down" for physicians looks like. Compared to midlevels and NPs, the amount and depth of knowledge that physicians are expected to have is so far above that it isn't even remotely in the same universe. I guess it's not surprising, then, to come across this case of a poor college student (a classic high-risk population for meningitis, by the way) dying in his dorm room because the NP who evaluated him not once, but twice, completely whiffed and chalked up the patient's headache to "migraines". Meningitis is one of those things that an emergency physician would include on the differential for headache with his or her eyes closed.

Suddenly, giving inadequately educated and inadequately trained midlevels full practice rights doesn't seem like such a good idea...