Nurse and Techs aren't necessary; physicians can do their jobs without them.

If I was a doctor, making $500,000 or more, I'm sure I could probably do most everything necessary without absolutely needing the services of a nurse. However, if I'm making that kind of money, I think it would be nice give up $40,000 or more to a nurse so they could handle the more mundane stuff for me. I'd probably be willing to pay even more to some hot looking nurse Goodbody type who could perform even more services for me should I be so lucky. Plus, with enough nurses handling the basic stuff for you, it would free you up to see more people, diagnose them, and press on.
 
In larger health care organizations where the MD's, NP's and PA's are expected to see a certain number of patients throughout the day and still maintain a high level of patient care, support staff such as RN's LVN's and MA's are vital to the work flow. By taking care of basic patient care they allow the provider to spend more time treating the patient during the appointment as well as properly documenting the visit afterward.

Can a provider do everything during the course of a visit? Certainly, but it is a waste of a valuable resource, time. It reduces the number of patients a provider can see during a typical day and actually increases the cost of care to those patients. In an age of managed healthcare, support staff are a cost effective component of good patient care. That is my experience, at least. YMMV.
 
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As a recent consumer of hospital services, I would have to disagree, at least as far as nurses go. Doctors are scientists specializing in diagnosing and prescribing treatment for dissease. Nurses are patient care specialists who focus on the comfort and welfare of the patient while the treatment of the dissease takes it course.

These different focuses require predominantly different skill sets (with a little bit of overlap) and both are completely neccesary for the successful treatment of a patient.

I beleive that the rise of the medical tech field was the result of attempts to cut corners by relegating a lot of the less patient-interactive duties of nurses to a lower-paid individual who did not have all of the patient-care training and experience. While not completely neccesary, they do provide thier use by lowering overalll medical costs.
 
Ivor the Engineer said:
In a discussion I'm having over in the Business and Economics sub-forum a couple of posters have expressed their opinion that physicians do not require nurses and techs to perform their job. E.g.,

http://www.internationalskeptics.com/forums/showpost.php?p=4369287&postcount=74

I was wondering what other posters may think about this idea?

:)
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Some people haven't a clue. Medical systems do not employee redundant people.

All the parts help it work. Interviewing patients and providing care are something doctors are already limited in.
 
I'm a PCT, and the idea that physicians don't need nurses or techs is just dumb. Often the physician overlooks important info, or it hasn't made it into the chart yet; there's often a knowledge gap. And it all waits on labs- nobody knows much of what they're up against until the labs come back.
 
Nurses do a different kind of job that doctors. Patients aren't just defective machines. Nurses provide CARE, doctors provide repair.

Of course you may be able to teach doctors to do nurse work, but why should you? That would not be cost-effective.

Technicians? I have worked with medical electronics. Have you ever seen a doctor operate a piece of technical equipement? I have. You don't wanna be on the receciving end of that.

In principle, all people could do all kinds of work, but there's a reason some are watchmakers, some are blacksmiths, and some are musicians.

Hans
 
Oh, him?

I wonder what he means by "tech"?

Could a doctor do everything that a nurse can do? At a pinch I suspect probably, though they cost a lot more per hour.

However, by "tech" does he mean technician, or technologist as I believe the correct word is in America? If so, not a prayer.

Technicians know about the techniques of analysing lab samples, the principles of that analysis, how to do it and how reliable the results are. Technicians know about the proper functioning of big expensive machines that analyse lab samples, take x-rays, take CT and MRI scans and so on. Technicians know about calculating the right amount of a rapidly-decaying radio-isotope to inject to be able to image the required information wiout frying the patient. And so on.

Now if you take each of these technical areas, there will be a few doctors, the top consultants especially, who have mastered the technical aspects to the same depth the technical staff have. But if you gave the average generalist a blood sample and told him to run a blood count on it, he'd just say, haven't a clue, it's not my job anyway.

Yes, you could train a doctor to do these jobs, just as you can train a junior science graduate to do these jobs. But doctors don't come out of medical school with any feckin idea about the principles of laboratory analysis.

Rolfe.

PC. What MRC_Hans and Magnifico said.
 
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My god, I pay enough money at the hospital already. Now all I want is for highly paid doctors to take on much more training, and then pay them about $100/minute (only a slight exaggeration in the US) to draw my blood, run it down to the lab, help me get into the bathroom with my IV bag, etc., etc., etc., all while the person in the next room is dying for lack of a doctor. Ya, that's the ticket.
 
It really depends on what nursing care or technical analysis is required and how often a doctor has to do this. Some things can be learned easily, even the technical analysis. Many doctors learn specific technical tasks in a research setting or out of pure necessity. But depending on the workload and the complexity of some parts of medical care it makes no sense to have a doctor do all the technical tasks in the same way that a doctor does not have to know all the details of a specialty he/ she does not specialize in.
For a general practitioner it may be true that the presence of nurses or technical staff makes no sense, but as the requirement for nursing care and the need for technical analysis increases and becomes more complex and time-consuming, nurses and technicians become increasingly necessary to keep health care affordable and efficient and reduce the workload for doctors who have another specific task.

Doctors are required to know how to interpret the results and understand a method of analysis, but they don't have to know how to load the sample, clean the machine, know what all the alarms mean or anything of the sort. Ofcourse, if the supervisor is a doctor, which often is the case, then he/she will most likely have specific knowledge on the subject. The reason for the requirement is logical: you have to be able to tell the nurse or the technician what you want from them and understand what they try to tell you to find a solution to the problem. Ofcourse, since a technician or nurse has a specific set of tasks in which they specialize, their expertise in this specific field is often greater then a doctors if it's not a task that doctors perform regularly. In all cases the ability to communicate with other staff to find a solution and manage a diagnostic and therapeutic path is the main reason why doctors expand their knowledge beyond their own field of expertise, not necessarily to actually perform the task.

Nurses see a patient for a longer period of time, focussing on the day to day care of a limited amount of patients and see many things that are easily overlooked in a routine examination. Depending on the nurse, a nurses hunch is often more valuable then a single clinical assesment. In the same manner the clinical experience of a doctor is more then being able to run a checklist of symptoms, but requires the ability to asses the severity of symptoms and associate anything that might be out of the ordinary with a specific cause or a set of causes while choosing the appropriate (technical) way to determine whether their assumptions are correct and determine a correct treatment.

Apart from being very inefficient and costly, requiring doctors to do all the nursing and technical tasks, makes as much sense as deciding that doctors should be experts in all specialties and underestimates the value of technical and nursing staff and the added quality of care they provide.

SYL :)
 
"Nurse and Techs aren't necessary; physicians can do their jobs without them."

Um no, those who would think otherwise are uninformed. No, I'm not going to take the time to inform them. It's just silly.

credit: My wife is an OR nurse.
 
I object to being misrepresented, and in a different sub-forum!

Ivor, I object to you mis-paraphrasing me and subjecting me to a proxied attack by starting this thread.

What I said--as others on this thread have noted--is that a doctor could do what the nurses and "techs" (by which I mean the medical office assistants, not the technicians who run specific imaging equipment); but that it is more efficient to have the higher level of knowledge do only those functions that require that level of knowledge. My argument was not that the lower-level people were not desirable, only that without a doctor, the clinic would not function.

This was in response to your assertion that the highly-paid people in a firm don't deserve to be paid much more than the lowest-paid. I used a medical clinic as an example of why there are tiers of compensation, which reflect the relative value of a person to the firm.

I did not say, or imply, that nurses and technicians are not a value to a medical practice.

Whether this thread represents a deliberate smear attempt on your part or genuine ignorance, an apology is in order, sir.

I await your response, Miss Kitt
 
I am a paramedic.

An MD does not need a nurse to do his job. A nurse has too much of her work to do to be an MD also.

MD, PAs, NP, Nurses, CNAs, Respiratory Therapists, Radiaology Technoloigsts, Cardio Perfusionists, lab tech and paramedics have their own job to do. MDs can not do it all.
 
Looks like you're attempt is busted Ivor... evading the argument by moving the discussion :p
 
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Miss_Kitt said:
Ivor, I object to you mis-paraphrasing me and subjecting me to a proxied attack by starting this thread.

What I said--as others on this thread have noted--is that a doctor could do what the nurses and "techs" (by which I mean the medical office assistants, not the technicians who run specific imaging equipment); but that it is more efficient to have the higher level of knowledge do only those functions that require that level of knowledge. My argument was not that the lower-level people were not desirable, only that without a doctor, the clinic would not function.

This was in response to your assertion that the highly-paid people in a firm don't deserve to be paid much more than the lowest-paid. I used a medical clinic as an example of why there are tiers of compensation, which reflect the relative value of a person to the firm.

I did not say, or imply, that nurses and technicians are not a value to a medical practice.

Whether this thread represents a deliberate smear attempt on your part or genuine ignorance, an apology is in order, sir.

I await your response, Miss Kitt
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As I see you are from the States, the set up here in the NHS in the UK is a little different to what you have and here in our hospitals, the NHS could definitely not run without nurses. The wards are run and staffed by the nurses (most understaffed at present still) and there is a Ward Sister or Charge Nurse in charge of the ward and here it is really looked upon as the ward belongs to the nurses.

The doctors come and do rounds, but they are not on the ward all of the time in the way that the nurses are to provide round the clock care for patients.

In the NHS, if there were no nurses, it would collapse, which is why nurses are prohibited from striking. They are needed and I have to say that as well as doctors perform their jobs, they could not do the job of the nurse in the same way that a nurse could. This is why nurses have specific training in the way that they do to provide patient care. Their role is totally different and they are a very much needed and valued part of the team, especially here in the UK. Can't speak for the US. Perhaps your healthcare and hospital set up out there is different, but surely you still need nurses there too?
 
Ivor the Engineer said:
In a discussion I'm having over in the Business and Economics sub-forum a couple of posters have expressed their opinion that physicians do not require nurses and techs to perform their job. E.g.,

http://www.internationalskeptics.com/forums/showpost.php?p=4369287&postcount=74

I was wondering what other posters may think about this idea?

:)
Click to expand...



After having read this thread and the one housing the linked post above, I think you're reading way too much into those posts. In a very strict, literal sense, a physician does not need a nurse to do his job i.e. his/her specific duty of diagnosing symptoms and determining courses of action - but the doctor cannot properly execute his job without the nurse(s). It may be logically argumentatively correct to say that a doctor does not need nurses or techs to do his job, but it is a meaningless hypothetical construct. Consier other examples:
  • A ship's captain does not need the seamen in order to do their job of determining what the ship does, where it goes, and how things are done.
  • A US football quarterback does not need his linemen or other skill positions to do his job of reading the defense and predicting where the ball should either be thrown or run to.
  • A chef does not need the sous-chef or prep workers in order to design and prepare the menu
But these are all just complex ways of saying that different people have different duties within an organization. A doctor may not need a nurse in order to make a diagnosis, but said doctor would be a fool to attempt to care for the patient without the nurses, technicians, and all other elements of a healthcare giving team also contributing. The fact that the nurse does not normally execute the act of making diagnoses for the doctor (I'm obviously excluding nurse-practitioners in this example, and highlighting office or hospital situations where doctors are available) does not mean that the doctor can execute the remainder of his job without the nurse's activities. The doctor requires a lot of information from a nurse in many situations (for example, in a clinic where the nurse takes the history and records what the complaint and symptoms are). The nurse is not technically directly involved in the execution of the doctor's core duty, but the core duty cannot be carried out in the absence of the other functions the nurse carries out.

Extending the example: A ship's captain simply cannot get the ship where it needs to go without the engineers taking care of the engines, the navigator determining proper courses, and the various seamen handling the mundane duties of a ship. And, an NFL quarterback's job becomes difficult without his linemen helping determine the sort of defense being thrown at him by simple virtue of who they block and where, and the quarterback's job actually becomes meaningless in the absence of the other skill positions because they're the ones he's supposed to deliver the ball to.

Now, other than creating an interesting mental exercise in parsing the statement "... that physicians do not require nurses and techs to perform their job", I really don't understand the purpose of this thread. It's obvious that there are multiple levels of meaning in that statement, and that a direct, strict, literal meaning of the statement is useless when considering the overall operation of an organization. So, question: What's the point of the OP? I'm afraid that I'm missing something here.
 
The question, IMO, should be: can nurses and technicians do their job without physicians? I think there should be more nurses, with their own facilities. They could treat less serious conditions, like broken arms and such. I don't think that kind of stuff needs a doctor, so having to pay for one doesn't seem very efficient.
 
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Tomwaits, the kind of job you're thinking of is not Nurse, but Physician's Assistant. They have bachelor's degrees in medicine instead of MDs, which is the same amount as some nurses (although there are different "levels" in nursing and some nurses have an associate's degree instead), but the kind of training they've received is different from the kind of training nurses get. They're taught some amount of scientific analysis for diagnosis and prescriptions for treatment. Nurses are taught a different set of skills for taking care of all of the patient's other needs while a doctor or PA does the diagnosing and treatment-prescribing.

Ivor, running away from a discussion you were failing in just to try to recruit others who weren't involved for help in taking ad-hominem potshots at your opponent from a safe distance is not only disgusting, but also just pathetic and lame.
 
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