Recently, a post in the "Urgent Care Nurse Practitioners!!" Facebook group (why does the group name need two exclamation points?) caught our eye. Kelly Pearson, a family nurse practitioner from Minnesota (which is a full practice authority state), just attended this year's FMX conference in Chicago, IL. FMX ("Family Medicine Experience") is a high-profile annual educational conference presented by the American Association of Family Physicians (AAFP). Per NPI records, Ms. Pearson is employed at a clinic in Maplewood, MN under M Health Fairview.
Regrettably (for her, because we reget nothing), Ms. Pearson was quite dissatisfied - one might say extremely butthurt, even - after attending the FMX conference. May we kindly suggest to her to consider changing her first name to Karen?
We are aware of the identity of the physician who presented the specific talk on minimizing medicolegal liability that Ms. Pearson attended. Quite frankly, there's nothing false or inaccurate about the statements here. Midlevels (especially nurse practitioners, given their terribly subpar training with on average <5% of the education and training hours of a residency-trained, board-certified physician) are a liability to physicians, and physicians should be seeing all their patients anyway, especially if they are put in the unenviable position of having to supervise midlevel providers. We're not just blowing hot air here - a recent ACEP research report on nurse practitioner and physician assistant malpractice cases found that 25.7% of such cases "found negligence on behalf of the physician", "with errors in diagnosis emerging as the most common category in [the] series of cases", and that "physicians are named in most of these cases, although they actually saw or heard about the patient in the minority of cases." Therefore, one might even go so far as to say that for physicians, midlevel providers are dead weight, especially for physicians who are employed by large corporate health systems and are contractually obligated to supervise midlevels and rent out their medical licenses for use as malpractice liability shields.
There's nothing unreasonable about suggestions #2 or #3 either - as physicians, we can all attest to the stupidity of questions often asked by midlevels (again, especially nurse practitioners) as part of "curbside consults". The quality of a question depends on the quality of the person asking it - garbage in, garbage out. Specialist physicians can certainly provide no shortage of examples of inappropriate, low-quality patient referrals made by nurse practitioners.
Apparently Kelly isn't a fan of the whole "us and them" mindset that has permeated relationships between physicians and non-physician providers such as nurse practitioners and physician assistants. Perhaps if the latter group didn't have laughably poor, non-standardized clinical training and stayed in its lane under the direct supervision of physicians, we wouldn't be having this "us and them" problem. Instead, we see nurse practitioners, emboldened by the American Association of Nurse Practitioners, spending more time lobbying for independent practice rights than learning actual fucking medicine and opening up Botox-injecting, semaglutide-peddling med-spas and "wellness centers" at a pace that would put Dollar General to shame, and simultaneously diagnosing all of their patients with ADHD while handing out DEA-controlled stimulants left and right, all under the guise of "improving access to care".
But really, the funniest part about all this is that Karen, err, Kelly, not only decided to attend a conference she didn't like for two more days, but thinking about asking for a refund. We've yet to see a conference offer a refund prior to the registration deadline, and certainly not if you've attended the entire goddamn fucking conference. Would it really have been that hard to just leave the fucking conference and be a normal tourist in Chicago for a couple of days?
Just as entertaining, though, are the subsequent comments on the Facebook post. We present a collage of the best ones here:
What the fuck is the AANP going to do, other than cry about it? Physicians, and certainly their representative specialty organizations like the AAFP, aren't accountable to the AANP and couldn't care less what the AANP says. Remember - according to the AANP, nurse practitioners practice "healthcare", not medicine. Conversely, the American Association of Family Physicians represents the views of family medicine physicians (including the author of this post, who is an AAFP member). The purpose of the AAFP is to advance the profession of family medicine and advocate for the interests of its constituent physician members, not to "acknowledge" the existence of NPs and make said NPs feel good about themselves and include midlevels in physician social gatherings. Seriously, why the fuck would you go to a conference for physicians, expecting to find exhibits, career counseling, and recruiting for NPs? How fucking stupid is this Karen? It's analogous to being a card-carrying Democrat showing up to a Trump MAGA rally to extol the virtues of Joe Biden and expecting to have a good time. Hopefully she uses better clinical judgment when it comes to patient care. Bottom line: don't play in a sandbox that doesn't belong to you.
So what happened after Ms. Pearson decided to give the physician presenter "a piece of her mind"?
Indeed, most physicians today couldn't be faulted for assuming by default that nurse practitioners are incompetent, especially if they are aware of the glaring educational and training deficiencies present in all modern nurse practitioners being pumped out by the smorgasbord of online diploma mills that currently exist. And interestingly, it appears that many midlevels, as evidenced by the above comment from NP Sarah, consciously make the decision to never work with physicians again and "work in a place where there is only NP/PAs". Apparently, the solution to being called out for being a clinically incompetent idiot and endangering patients is to put your head down in the sand. Unfortunately, the natural progression of patients' medical illnesses and disease pathophysiology doesn't care about your fragile ego.
Hope you had a safe trip back to Minnesota, Karen. Don't let the door hit your feelings on the way out!