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When you don’t know what you don’t know, patients suffer. Threads: Why Primary Care Physicians Are Critical. PCPs in states where NP’s practice independently share their stories. We begin in Idaho: /thread #1
In ID, NPs practice independently: In 2 consecutive wks (free clinic) PCP found 2 cancers, missed by NPs. 70 yo F w/nausea, bloating, early satiety. NP diagnosed GERD, began PPI. Actual diagnosis: metastatic cancer. /2
Patient looked ill and 7 months pregnant-not subtle. Yet NP thought problem was reflux. PCP saw patient coincidentally for “simple med follow up visit”. Walked in room, made diagnosis in seconds.Diagnosis obvious to physician,not even considered by NP. Devastating to patient. /3
The next week, 40 yo smoker came with "something in the back of [his] throat", there for >1y and had been seen by several NPs without diagnosis or workup. Mass looked like disco ball hanging off uvula. All NP had to do was look. Straight to ENT surgeon for cancer treatment. /4
Idaho PCP had diabetic amputee present after trauma to remaining foot. Patient seen by NP, given oral antibiotic, told to come back in 3 WEEKS. PCP took one look at the foot and called hospitalist for direct admit--and patient still lost his last leg. /5
Another: 100lb wt loss, can't swallow. Pt very rural, so PCP thought he had no physician. He didn’t, but NP made home visits--had been following him entire time his wt was
. NP even told this PCP (too late), “I thought maybe he should see GI.” Esophogeal cancer. /6
. NP even told this PCP (too late), “I thought maybe he should see GI.” Esophogeal cancer. /6
I’m kind of traumatized by what I’ve seen missed by NPs, says this PCP. Yes, anecdotes, but can’t ignore real stories of patients harmed by NPs under-educated for the work they are doing. Team-based care is best. Want to reach this PCP? Contact us: https://www.physiciansforpatientprotection.org/about-us/contact-us/ /fin
@CMADocs @SenToniAtkins @Portantino @SenatorPatBates @SteveBradford @SenBrianJones @BobWieckowskiCA @AmerMedicalAssn #AB890
