Support Your Local Provider!
I wasn’t going to discuss some recent drama with Psych NPs and Physicians but there’s a real crisis exploding with mental health. The drama started with this online conference basically targeting NP’s independent practice and capabilities.
The panel included a nurse explaining how she wasn’t satisfied with her NP education so she dropped out and agreed that NPs should not be independent due to their lack of training. Furthermore, screenshots from Facebook were posted on other social media outlets to show how NPs were incompetent.
So a quick PSA- be careful what you post online and keep identities or people involved hidden. The drama started all this nastiness between NPs and doctors and throughout the entire situation, all I thought about was how the lack of access for mental health is getting worse.
This post is not to target any person, group, or profession so I’m not going to reference them or the screenshots. This is just my little 2 cents to send some positive vibes and make the case that America has a mental health crisis and we need to FULLY support our mental health providers.
About AB890 and California MADNESS
At the moment, California has a bill called AB890 to help make NP practice more independent (update: it passed). It’s far from perfect but it’s something. Why is this so important? Because everyone knows California is a mess with the taxes, CRIME, cost of living, weird regulations, and bureaucracies. It makes no sense!
I was going to do locums because a recruiter told me due to the COVID pandemic, many things were waived. WRONG. The board of nursing said I have to apply for my RN license, wait a few months for the approval, apply for my NP license then wait a couple of more months, and eventually the process will be over. So to work in California (if you don’t have a prior license there), it may take at least >half a year to apply and this doesn’t include the credentialing process.
The recruiter tried to make me feel better and said well the physicians have to pay additional fees and taxes then after a while, they don’t have to keep paying… I don’t know if that’s still true but it makes no sense. And who’s seeing all these patients in the meantime?
If you do some rough math, there are ~40 million residents in California, and divide that by ~5900 psychiatrists (Sacramento Bee), it will equal ~6,780 possible potential patients per physician. These numbers don’t include undocumented citizens, homelessness, etc. and if it’s specialized care like pediatrics, then the access to care is just horrific.
Even if you include all the physicians and do the numbers in any state, you’ll see a mental health crisis across this entire country. The access to care is so scary that a person will have to do something drastic just to get any kind of attention. How many times do we have to see someone on the news to realize something went wrong and is lacking mental health needs? It’s not fair for the providers or our most vulnerable populations to NOT have more options and additional help.
Back to the Drama
The online panel was very negative and disappointing, it offered no solutions about access to care, just assumed doctors need to lead and how other providers are not prepared. I don’t know why they interviewed someone who dropped out of school. Like how can you interview someone who dropped out of school to discuss the educational problems of a PROFESSION that the person is not in? The irony of it all.
Although it wasn’t intentional, it was like a hit job on APRNs to paint us with one brush, incompetent. Plus, a nurse cannot represent an NP, it doesn’t matter how well the person presents the argument. Of course, some people were on social media rooting for her but it was awkward like doctors or other healthcare workers can’t EVER make poor decisions.
It’s very unfortunate when a person doesn’t have a good learning experience but people should always be selective with their education. Likewise, a person has to be selective with employers because some physicians are not the best collaborators. For example, if there’s a language barrier with the doctor that can significantly affect the working relationship even if the doctor was trained at Harvard.
So another PSA, please invest the time, energy, and effort to find a proper psych program or any education involved in healthcare. Online schools may be the norm due to COVID and for many other unforeseen circumstances, it doesn’t have to be a liability.
What about Physicians Going to that Caribbean School?
There are some who believe that the Caribbean medical school is questionable but they continue to produce doctors and fill a need. I wish my psych program was in the Cayman Islands. The program could switch midway into marine biology and I would just learn about the mental health of turtles! The point is some doctors may have issues with their education while others may have the best education but go on to commit horrific crimes such as Dr. Larry Nasser and that Michael Jackson doctor, it’s a whole list.
I’m also not saying the NPs and nursing education are not without fault but you have to look at things in a more reasonable fashion. If someone commits a crime or if there’s a problem we have to give it due process and in the meantime, improve the system but don’t punish those that do not have an offense or had a quality education. My brick and mortar school was NO JOKE.
Looking Forward
What’s interesting is how there are other factors at play and NPs are the least of them:
- There’s a decrease in residency slots and people typically do not go to school for a psych career.
- More facilities are outsourcing care. Corporations will rather pay more for temporary workers than consistently give permanent workers more pay/benefits. It means the corporations are making the major decisions, not doctors.
- Insurance companies don’t like spending money, so they don’t always cover extra costs, hence hiring an NP is more affordable than a physician. I asked my job about at least hiring another doctor and they said they’re “overqualified” aka we basically can’t afford them.
In Conclusion
The basis for fully supporting NPs involves improving the access to care and remaining helpful. I would never go on social media to disparage or harass any person or group. I don’t like adding fuel to the fire while people, including us professionals, are truly suffering from the demands. I also feel like they probably couldn’t get a Psych NP on the panel because we are currently working our BUTTS off, most of us barely use social media or have a life. The need for mental services is that extreme!
Like everyone else, I’ve had good and bad experiences with many professional people, but know better than to make any major generalizations. This is why you do need to seek a good education. We all have our faults and learning is a lifelong process, no one should be humiliated for asking for help, regardless of the outlet…
Lastly, I hope our relationship with physicians will continue to prosper. I brag about them all throughout this website and in general. There were many doctors backing the NPs as well because we ultimately want to help and NOT replace anyone. I LOVE my collaborative physician but would love the ability to improve the access to care a lot more. Most of the time, the NP is alone anyway! That’s not my situation but it’s truly that chaotic behind the scene…I can say a lot more, but I’ll end my ramblings. Thank you for reading! Some links to check out:
- A List of Psych NPs with their own practice and information about telepsych!
- Florida & Massachusetts: recently signed laws for an FPA process!
- Mental health ‘tsunami’ looms: Can California prevent a surge in suicides? by Cal Matters
- Nurse practitioners fight to have more authority in Texas. Why does that worry doctors? again some generalizations as if doctors don’t make terrible mistakes.
- Psychiatrists are getting burned out -Business Insider: This is what happens when mental health providers are lacking!
- Jury Awards Huge Verdict After Physician Fails to Diagnose Rare Disorder by Monthly Prescribing Reference: an example of a physician who made mistakes.
- The discrimination against NPs must stop –Kevin MD: a 2019 op-ed by a physician who believes in recognizing the value of NPs in healthcare.
- United States has 15.6 psychiatrists for every 100K people!
- 10 Ways to Spot a Diploma Mill School –Get Educated & Make Sure Your Psych NP School is Accredited!
UPDATE: AB890 was signed into law on September 29, 2020!
Under the new law, nurse practitioners will be able to see patients in their own practice, but only after working under a doctor’s supervision for at least three years. California joins 38 other states that grant some level of autonomy to nurse practitioners — but it doesn’t take effect until 2023.
- WHAT THE LAW DOES? AB 890 expands the role of nurse practitioners and allows them to practice independently in some settings, without a supervising physician. State Assemblyman Jim Wood (D-Healdsburg) pitched the bill as a way to help combat the state’s provider shortage.
- WHO SUPPORTS IT? Nurse practitioners have been trying to lift restrictions on their scope of practice for years. The nurses’ union, as well as the state’s hospital association, were among the bill’s supporters.
- WHO’S OPPOSED? California’s doctor lobby argued that the legislation posed a threat to patient safety and that it wouldn’t necessarily guarantee growth in the provider workforce.
- WHY DOES IT MATTER? Nurse practitioners are highly trained nurses with a master’s degree, who work largely in primary care, an area of great need in the state. By some projections, California will need about 8,200 more primary care doctors by 2030.
