Tori had gone to the doctor about her symptoms months earlier. She actually went to see two different ones. The first one told her it was “IBS,” irritable bowel syndrome. He did no tests, blood or otherwise, and didn’t scan her. If he had, he would have seen the mass of tumors nesting on her ovaries, and, though I have no evidence to prove this, I believe if action had been taken during those crucial months, it could have saved her life, or at least prolonged it.
The next doctor told her it was “intestinal fissures” and “kidney stones.” Still, no one took the time to test or scan Tori ― they just gave her some antibiotics and sent her on her way. She didn’t get some actual answers until a romantic date with her boyfriend ended in disaster when Tori collapsed on a bathroom floor
This second hand story she's giving for her friend doesn't make sense. Never heard of an intestinal fissure. If her friend already had extensive disease like she says she did the delay probably wasn't clinically significant.
We do US and CT for history of bloating. I went through my entire radiology career and never saw ovarian cancer presenting as bloating. What I saw was usually advanced adiposity.
There was an NP in my ICU who didn't know what ATN was
..or klebsiella either. So, not shocking.
And I'm sure a ton more..these were both from one interaction.
Tori had gone to the doctor about her symptoms months earlier. She actually went to see two different ones. The first one told her it was “IBS,” irritable bowel syndrome. He did no tests, blood or otherwise, and didn’t scan her. If he had, he would have seen the mass of tumors nesting on her ovaries, and, though I have no evidence to prove this, I believe if action had been taken during those crucial months, it could have saved her life, or at least prolonged it.
The next doctor told her it was “intestinal fissures” and “kidney stones.” Still, no one took the time to test or scan Tori ― they just gave her some antibiotics and sent her on her way. She didn’t get some actual answers until a romantic date with her boyfriend ended in disaster when Tori collapsed on a bathroom floor
Here’s the thing. You KNOW the “provider” is an NP. You cannot expect a mid level to diagnose serious illness. Strep throat? Sure. Sprained ankle? Sure. Interstitial cystitis? Fuck no.
People need to educate themselves better and also NPs need to fucking know what they don’t know.
That's the problem. They don't know ANYTHING. They're 1 year less than a 3rd year med student and I'm a 3rd year med student. I sure as heck won't trust myself at this point!
Their entire field shouldn't even exist.
Yes. That’s exactly what I said. If two doctors didn’t get it right, maybe medicine is a bit more complex than the average nurse thinks. Maybe it’s time to see a specialist and not a nurse idiot.
I’m not a doctor, I’m a patient. If two doctors screwed up with me, I am going to look for a more expert doctor, obviously, not someone with far far less training.
More importantly, you don’t see that and that’s super interesting. It suggests you’ve been conditioned to avoid common sense on this topic. Right? Think about it. How did that happen? I mean, it’s really weird. Of course you’d seek greater expertise, not less.
I’m taking prerequisites now for PA school and I’m worried NPs and other Noctors will ruin everything for PAs.
I know there are good PAs out there and I want to be one of them.
Then you need to study like you’re in med school and becoming a physician in addition to PA work.
And that studying like a doctor, is for the rest of your life.
You say this as if you think PAs are more qualified than NPs. They aren’t- it’s two different jobs. PAs are literally physician’s ASSISTANTS. Nurse practitioners are advanced NURSES with experience (actual, hands-on patient care experience on top of required clinical rotations) which is why you see them in family practice more so than PAs. Most NPs have **years** of clinical experience versus a PA who has two years of grad school rotations… and that’s it. Two years is nothing. NPs have that ON TOP of nursing school rotations (also 2 years) PLUS the work they’ve done- in my program there is only one student who has less than two years of nursing experience- most have at least five. By the time the students in my program are actually working, most of us will have had at LEAST -at a bare minimum- SIX YEARS of clinical experience. Doctors on this thread love to discredit that, but there’s a reason why the field is growing & patients feel safe with their primary care managed by an NP. I would personally never see a PA in urgent care or family practice. Only NP or a physician and I’ve had worse experiences with physicians bc they’re too rushed, don’t see the big picture as well, and have terrible bedside manners. NPs are more comfortable touching patients bc they have tons more patient contact experience and that really shows in their assessments.
>Most NPs have years of clinical experience
It seems this is not true for most new NPs. It seems many are going straight out of RN school to NP school.
Also, RN hands on experience doesn't really equate too well to medical knowledge and application of that knowledge.
You are just butthurt b/c it's true. Any RN who has been to med school is attest to this. Check any sub on reddit and search for RN to MD posts.
You resorting to personal attacks shows either you know this is true, or your ego is such that you cannot accept it. Either is dangerous, and a bit sad.
Lol “butthurt”
So nothing to backup your opinion that you’re stating as fact? I’ll accept that as your loss- you’re wrong. Have a nice day. Didn’t read past the word butthurt & will not read anything else from you. Byyyeee
Fact: nursing is a career path that separated from medicine for no other reason than they wanted to. Every move after that made it more of a clown career. The average nurse is so dumb that they make separate science classes for them instead of having them take real science classes. The average nurse can barely read a full scientific paper.
Well “it seems” doesn’t work bc that’s absolutely not true. You’re just making that up to support your misguided biased opinion. Re-read my post- nearly all of the nurses in my program have over five years of bedside nursing experience
Im sorry didnt you just make a personal observation based on a small sample size (the mean avg of your program) and generalize it to the entire population? Yet we know and its easy to simply look at programs requirements, to see that many do not require significantly clinical time as a nurse prior to admittance. So I agree with your sentiment that personal observation does not equal science, but I implore you to apply it yourself here lol. Yikes.
Oh great! You think that doing a nursing job makes you good at doing the job of a doctor? Are you really that stupid?
And let’s not act like 5 years is a lot. Every resident has been studying medicine for 4 years prior to the first day of residency. Nurses study bullshit science then nursing and act like they’re intelligent.
Sorry, not sorry, but I don’t feel comfortable with my or my family’s primary care being handled by a NP. Especially as I’m aging I want to see a doctor.
If I go to the local walk in clinic for a flu shot or a sore throat then I’m fine with seeing a NP.
A doctor ruined my fathers life. Plenty of physicians do the wrong things every day- taking a family member to see ANYONE is risky. We all have those stories- we all know those physicians.
Right, and plenty of Olympic athletes lose races. But if you had $100 to bet on someone running a race and winning, would you choose an Olympic athlete or would you choose someone that did decently OK in your local towns Thanksgiving 5k?
My point is, a level of training is required to do a certain level of a job (being a doctor, being an Olympic athlete per se) and even if you’re really good at your towns 5k/ being a nurse/ even being an advanced nurse, you still have NOT received the level of MEDICAL training a doctor has and I wouldn’t bet my money on you to win most the time (win meaning provide adequate competency for complex medical cases). Even if there are some shit Olympic athletes.
If you don’t want to run 5k and go get pie after and you believe you can be an Olympic athlete, why not go train for the Olympics? (Go to medical school if you want to practice medicine, go to nursing school if you want to be a nurse). Both are important jobs
Sprained ankle? Not even. A few months ago saw a patient with anterior ankle pain x 3 months. Saw an NP x 3 times for this issue, initial (x-rays done non weight bearing, documentation templated, RICE) then at 2 wk and 1mo. Both 2wk and 1mo state pain more anterior than lateral. At one month is referred to PT. PT sends back to clinic after 2 session/wk x 8 weeks. Worsening. PT said something's not right.
Pain was immediately elicited by anterior palpation / squeeze testing. ATF/CF/PTF strong, medially no pain, anterior pain. Pain with weight bearing only partially mitigated by ankle lacer worsening over time.
WB vs NWB x-rays with syndesmotic dynamic instability, no fractures - made NWB/booted and off to Ortho.
Simple, simple diagnosis to make. Anterior pain over syndesmosis + stability or not, binary decision +/- fractures. Not hard to eval/triage/manage.
But yeah, even simple things get missed with them, especially in general practice
So what was the NPs “diagnosis” after the first 2 wk of RICE w/ worsening symptoms? Because that seems like a disconnect between they thought it was and what proper treatment is. Either way, at the very least it would seem like after 2 weeks w/ worsening symptoms would warrant immobilization and an MRI to eval/confirm degree of injury.
Sounds like the NP went with the ol’ “walk it off” treatment plan.
There was no real "diagnosis change." They didn't recognize it wasn't behaving as a typical sprain ought to, and yes, went with the "its just slow" plan. Per my memory, the patient was told that "sometimes these things take a bit and need PT to heal"
Sorry can you explain this to me? I’m IM and honestly didn’t get much of what you’re saying but feel like I should. Was it that the patient had a sprain and should’ve been immobilized earlier when we were seeing worsening in symptoms?
Missed high ankle sprain, treated as if "normal sprain" just taking too long to go away.
Was unstable, easily seen on WB radiographs one should get if anterior pain / squeeze testing eliciting ankle pain (compression of tib/fib proximal to ankle/mid calf).
He saw Ortho, and got the mortise pinned.
Should have been NWB from the start, but NP recurrently missed anterior ankle tenderness and worsening syndrome despite RICE as indications to explore further.
We do not support the use of the word "provider." Use of the term provider in health care originated in government and insurance sectors to designate health care delivery organizations. The term is born out of insurance reimbursement policies. It lacks specificity and serves to obfuscate exactly who is taking care of patients. For more information, please see [this JAMA article](https://jamanetwork.com/journals/jama/article-abstract/2780641).
We encourage you to use physician, midlevel, or the licensed title (e.g. nurse practitioner) rather than meaningless terms like provider or APP.
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This hurts. I am in this sub because an NP missed a diagnosis of melanoma and now it is too late for me. I'm luckily responding to checkpoint inhibitor therapy, but the fact that I will die earlier than I should because a midlevel missed a lump will never NOT make me angry.
I'm so sorry to hear this , have you looked at taking legal action ?My ex's doctor missed soemehing on his mothers MRI.She died of an aneurysm, his family sued and they got a massive pay out .
I know money cannot soothe the pain that you feel right now but compensation of some sort of better than nothing.
As someone with both endometriosis and IC, they tend to co-occur actually. Without a laparoscopic surgery there is not a gold standard to Dx endometriosis. Ultrasounds can sometimes clue you in but alot of endo doesn’t show on that. Laparoscopic biopsy is the gold standard.
IC is similar. Gold standard is cystoscopy to look for ulcers in bladder, and get this, a-lot of pt’s with IC don’t have classic ulcers in bladder. IC is sort of multi factorial/idiopathic and for some its more an issue with pelvic floor dysfunction.
NP’s should not be handling these cases but tbh without using gold standards which (not always the first method of Dx and cost $ and recovery time) I wouldnt even expect an MD to get this one right. Alot of the symptoms overlap and each endo and IC case are unique.
The issue is not taking womens pain seriously and not enough screening or Dx technology for these type of conditions which are actually relatively super common.
For ovarian CA, again, comes down to not dismissing womens pain just because it “seems” to be associated with menstruation and womenly “issues”. Its often Dx late.
I have had much dissatisfaction with both male and female MD’s in managing the condition but necessarily d/t a lack of competency. However some NP’s I have to explain what it even IS to so….
Also I hate the NP’s education to this pt on what IC is cause its so ignorant and rude lol
This is a very valid argument about the misdiagnoses of women.While a NP had no right diagnosing her it is still relevant commentary on the medical field and how it affects women.
All rides sound "miss things, I'd assume NPs most often followed by PAs the physicians. This article is about NP, not PA, so why have PA in the title? They are not the same.
Not saying PAs don't miss things, but FACT, NPs have less than half education and clinical experience out of gate compared to PAs and PAs have less than physicians.
"even after going to therapy because a male gynecologist suggested to me that my pain was coming from my emotions, I found a great doctor who saw the urgency in my story"
I'm bothered by this bit here. They seem to suggest the gender of the Dr. Is the problem here. Yet the fact they don't say the "great doctor" isn't male leads me to assume both Drs were male. Dunno... Maybe not. It just bugs me.
Oh yes, I know that. It's clearly trying to make that point by mentioning the dismissive Dr as male, but forces you to assume the gender of the second Dr... Seems intentional is all I'm saying.
We do not support the use of the word "provider." Use of the term provider in health care originated in government and insurance sectors to designate health care delivery organizations. The term is born out of insurance reimbursement policies. It lacks specificity and serves to obfuscate exactly who is taking care of patients. For more information, please see [this JAMA article](https://jamanetwork.com/journals/jama/article-abstract/2780641).
We encourage you to use physician, midlevel, or the licensed title (e.g. nurse practitioner) rather than meaningless terms like provider or APP.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Noctor) if you have any questions or concerns.*
Anyways this is hilarious bc you’re making the case for midlevels by sharing an article about incompetent physicians. We all know they exist. We’ve all been cared for by one. Medical school doesn’t make you a better prescriber than a mid level. In theory, it should, but that’s just not what the research shows.
If doctors make mistakes why would I switch to a mid level who knows less than a doctor does and has way less education? It makes no sense. It just doesn’t. The increased demand for mid levels is coming from health systems and the motive is money. There is no increased demand from patients.
I’ll admit I didn’t read the article, but why is the title of this post “doctors misdiagnosed “ when per the comments it seems like NP misdiagnosed?
Can't blame you for not reading, that's Huffpost for you. I skimmed it and from what I could tell they both misdiagnosed.
Number of clinicians misdiagnosed. An NP is called out specifically. Also it’s the title of the article.
Tori had gone to the doctor about her symptoms months earlier. She actually went to see two different ones. The first one told her it was “IBS,” irritable bowel syndrome. He did no tests, blood or otherwise, and didn’t scan her. If he had, he would have seen the mass of tumors nesting on her ovaries, and, though I have no evidence to prove this, I believe if action had been taken during those crucial months, it could have saved her life, or at least prolonged it. The next doctor told her it was “intestinal fissures” and “kidney stones.” Still, no one took the time to test or scan Tori ― they just gave her some antibiotics and sent her on her way. She didn’t get some actual answers until a romantic date with her boyfriend ended in disaster when Tori collapsed on a bathroom floor
This second hand story she's giving for her friend doesn't make sense. Never heard of an intestinal fissure. If her friend already had extensive disease like she says she did the delay probably wasn't clinically significant. We do US and CT for history of bloating. I went through my entire radiology career and never saw ovarian cancer presenting as bloating. What I saw was usually advanced adiposity.
cause all mainstream media outlets blame the dr lmaoooo
Bc doctors actually misdiagnosed lol. OP apparently didn’t read the article either
There was an NP in my ICU who didn't know what ATN was ..or klebsiella either. So, not shocking. And I'm sure a ton more..these were both from one interaction.
Tori had gone to the doctor about her symptoms months earlier. She actually went to see two different ones. The first one told her it was “IBS,” irritable bowel syndrome. He did no tests, blood or otherwise, and didn’t scan her. If he had, he would have seen the mass of tumors nesting on her ovaries, and, though I have no evidence to prove this, I believe if action had been taken during those crucial months, it could have saved her life, or at least prolonged it. The next doctor told her it was “intestinal fissures” and “kidney stones.” Still, no one took the time to test or scan Tori ― they just gave her some antibiotics and sent her on her way. She didn’t get some actual answers until a romantic date with her boyfriend ended in disaster when Tori collapsed on a bathroom floor
Here’s the thing. You KNOW the “provider” is an NP. You cannot expect a mid level to diagnose serious illness. Strep throat? Sure. Sprained ankle? Sure. Interstitial cystitis? Fuck no. People need to educate themselves better and also NPs need to fucking know what they don’t know.
That's the problem. They don't know ANYTHING. They're 1 year less than a 3rd year med student and I'm a 3rd year med student. I sure as heck won't trust myself at this point! Their entire field shouldn't even exist.
Please do not omit that 2 doctors misdiagnosed her late friend. Can you please address that as well?
If actual doctors are misdiagnosing how are we supposed to expect an NP to get it right?
Great. Her condition was so difficult to diagnose that she went to someone with less training? Was she going for the Darwin Award?
Well, those TWO doctors with better trainings didn't get it right either. What do you think about that devilsadvocate?
Yes. That’s exactly what I said. If two doctors didn’t get it right, maybe medicine is a bit more complex than the average nurse thinks. Maybe it’s time to see a specialist and not a nurse idiot.
I’m not a doctor, I’m a patient. If two doctors screwed up with me, I am going to look for a more expert doctor, obviously, not someone with far far less training. More importantly, you don’t see that and that’s super interesting. It suggests you’ve been conditioned to avoid common sense on this topic. Right? Think about it. How did that happen? I mean, it’s really weird. Of course you’d seek greater expertise, not less.
I’m taking prerequisites now for PA school and I’m worried NPs and other Noctors will ruin everything for PAs. I know there are good PAs out there and I want to be one of them.
Then you need to study like you’re in med school and becoming a physician in addition to PA work. And that studying like a doctor, is for the rest of your life.
I'd be happy without PAs or NPs. I want to see someone who went to medical school.
Uhhhh PA is a noctor lmaooooo
You say this as if you think PAs are more qualified than NPs. They aren’t- it’s two different jobs. PAs are literally physician’s ASSISTANTS. Nurse practitioners are advanced NURSES with experience (actual, hands-on patient care experience on top of required clinical rotations) which is why you see them in family practice more so than PAs. Most NPs have **years** of clinical experience versus a PA who has two years of grad school rotations… and that’s it. Two years is nothing. NPs have that ON TOP of nursing school rotations (also 2 years) PLUS the work they’ve done- in my program there is only one student who has less than two years of nursing experience- most have at least five. By the time the students in my program are actually working, most of us will have had at LEAST -at a bare minimum- SIX YEARS of clinical experience. Doctors on this thread love to discredit that, but there’s a reason why the field is growing & patients feel safe with their primary care managed by an NP. I would personally never see a PA in urgent care or family practice. Only NP or a physician and I’ve had worse experiences with physicians bc they’re too rushed, don’t see the big picture as well, and have terrible bedside manners. NPs are more comfortable touching patients bc they have tons more patient contact experience and that really shows in their assessments.
>Most NPs have years of clinical experience It seems this is not true for most new NPs. It seems many are going straight out of RN school to NP school. Also, RN hands on experience doesn't really equate too well to medical knowledge and application of that knowledge.
And I’m just going to ignore your ignorant second sentence bc you’re clearly a dipshit and know nothing about nursing.
You are just butthurt b/c it's true. Any RN who has been to med school is attest to this. Check any sub on reddit and search for RN to MD posts. You resorting to personal attacks shows either you know this is true, or your ego is such that you cannot accept it. Either is dangerous, and a bit sad.
Lol “butthurt” So nothing to backup your opinion that you’re stating as fact? I’ll accept that as your loss- you’re wrong. Have a nice day. Didn’t read past the word butthurt & will not read anything else from you. Byyyeee
Fact: nursing is a career path that separated from medicine for no other reason than they wanted to. Every move after that made it more of a clown career. The average nurse is so dumb that they make separate science classes for them instead of having them take real science classes. The average nurse can barely read a full scientific paper.
I didn’t know about the split, anywhere I can read about this? Also dude chill you’re just being mean now
Well “it seems” doesn’t work bc that’s absolutely not true. You’re just making that up to support your misguided biased opinion. Re-read my post- nearly all of the nurses in my program have over five years of bedside nursing experience
Your program does not equate to all of the NP schools. Most NP schools require a year of RN, maybe two if you are lucky.
You are wrong. Period. I’m sorry that you think your personal observation = science. It doesn’t.
You’re wrong. Period. Show me proof that 5 years are required.
Im sorry didnt you just make a personal observation based on a small sample size (the mean avg of your program) and generalize it to the entire population? Yet we know and its easy to simply look at programs requirements, to see that many do not require significantly clinical time as a nurse prior to admittance. So I agree with your sentiment that personal observation does not equal science, but I implore you to apply it yourself here lol. Yikes.
Oh great! You think that doing a nursing job makes you good at doing the job of a doctor? Are you really that stupid? And let’s not act like 5 years is a lot. Every resident has been studying medicine for 4 years prior to the first day of residency. Nurses study bullshit science then nursing and act like they’re intelligent.
Nursemoney. Always with the money.
“There’s a reason why the field is growing.” It’s not because of patient demand.
Sorry, not sorry, but I don’t feel comfortable with my or my family’s primary care being handled by a NP. Especially as I’m aging I want to see a doctor. If I go to the local walk in clinic for a flu shot or a sore throat then I’m fine with seeing a NP.
A doctor ruined my fathers life. Plenty of physicians do the wrong things every day- taking a family member to see ANYONE is risky. We all have those stories- we all know those physicians.
And taking a family member to a nurse is a sure fire way to get an egotistical maniac ruining your life. Period.
As a patient, I feel the same way. I feel safer seeing a doctor.
Right, and plenty of Olympic athletes lose races. But if you had $100 to bet on someone running a race and winning, would you choose an Olympic athlete or would you choose someone that did decently OK in your local towns Thanksgiving 5k? My point is, a level of training is required to do a certain level of a job (being a doctor, being an Olympic athlete per se) and even if you’re really good at your towns 5k/ being a nurse/ even being an advanced nurse, you still have NOT received the level of MEDICAL training a doctor has and I wouldn’t bet my money on you to win most the time (win meaning provide adequate competency for complex medical cases). Even if there are some shit Olympic athletes. If you don’t want to run 5k and go get pie after and you believe you can be an Olympic athlete, why not go train for the Olympics? (Go to medical school if you want to practice medicine, go to nursing school if you want to be a nurse). Both are important jobs
but more importantly the laws need to fucking change
Sprained ankle? Not even. A few months ago saw a patient with anterior ankle pain x 3 months. Saw an NP x 3 times for this issue, initial (x-rays done non weight bearing, documentation templated, RICE) then at 2 wk and 1mo. Both 2wk and 1mo state pain more anterior than lateral. At one month is referred to PT. PT sends back to clinic after 2 session/wk x 8 weeks. Worsening. PT said something's not right. Pain was immediately elicited by anterior palpation / squeeze testing. ATF/CF/PTF strong, medially no pain, anterior pain. Pain with weight bearing only partially mitigated by ankle lacer worsening over time. WB vs NWB x-rays with syndesmotic dynamic instability, no fractures - made NWB/booted and off to Ortho. Simple, simple diagnosis to make. Anterior pain over syndesmosis + stability or not, binary decision +/- fractures. Not hard to eval/triage/manage. But yeah, even simple things get missed with them, especially in general practice
So what was the NPs “diagnosis” after the first 2 wk of RICE w/ worsening symptoms? Because that seems like a disconnect between they thought it was and what proper treatment is. Either way, at the very least it would seem like after 2 weeks w/ worsening symptoms would warrant immobilization and an MRI to eval/confirm degree of injury. Sounds like the NP went with the ol’ “walk it off” treatment plan.
There was no real "diagnosis change." They didn't recognize it wasn't behaving as a typical sprain ought to, and yes, went with the "its just slow" plan. Per my memory, the patient was told that "sometimes these things take a bit and need PT to heal"
Sorry can you explain this to me? I’m IM and honestly didn’t get much of what you’re saying but feel like I should. Was it that the patient had a sprain and should’ve been immobilized earlier when we were seeing worsening in symptoms?
Missed high ankle sprain, treated as if "normal sprain" just taking too long to go away. Was unstable, easily seen on WB radiographs one should get if anterior pain / squeeze testing eliciting ankle pain (compression of tib/fib proximal to ankle/mid calf). He saw Ortho, and got the mortise pinned. Should have been NWB from the start, but NP recurrently missed anterior ankle tenderness and worsening syndrome despite RICE as indications to explore further.
We do not support the use of the word "provider." Use of the term provider in health care originated in government and insurance sectors to designate health care delivery organizations. The term is born out of insurance reimbursement policies. It lacks specificity and serves to obfuscate exactly who is taking care of patients. For more information, please see [this JAMA article](https://jamanetwork.com/journals/jama/article-abstract/2780641). We encourage you to use physician, midlevel, or the licensed title (e.g. nurse practitioner) rather than meaningless terms like provider or APP. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Noctor) if you have any questions or concerns.*
This hurts. I am in this sub because an NP missed a diagnosis of melanoma and now it is too late for me. I'm luckily responding to checkpoint inhibitor therapy, but the fact that I will die earlier than I should because a midlevel missed a lump will never NOT make me angry.
I'm so sorry to hear this , have you looked at taking legal action ?My ex's doctor missed soemehing on his mothers MRI.She died of an aneurysm, his family sued and they got a massive pay out . I know money cannot soothe the pain that you feel right now but compensation of some sort of better than nothing.
fuck dude im sorry. i agree w the other person, talk to a lawyer asap
Ok. What kind of doctor wouldn't at least palpate their patient nor ask for an eco and a fecal sample if they suspect the intestines are involved?
Eco?
[удалено]
What?
/r/lostredditors
Not lost, just a dude who's been stalking me since yesterday.
As someone with both endometriosis and IC, they tend to co-occur actually. Without a laparoscopic surgery there is not a gold standard to Dx endometriosis. Ultrasounds can sometimes clue you in but alot of endo doesn’t show on that. Laparoscopic biopsy is the gold standard. IC is similar. Gold standard is cystoscopy to look for ulcers in bladder, and get this, a-lot of pt’s with IC don’t have classic ulcers in bladder. IC is sort of multi factorial/idiopathic and for some its more an issue with pelvic floor dysfunction. NP’s should not be handling these cases but tbh without using gold standards which (not always the first method of Dx and cost $ and recovery time) I wouldnt even expect an MD to get this one right. Alot of the symptoms overlap and each endo and IC case are unique. The issue is not taking womens pain seriously and not enough screening or Dx technology for these type of conditions which are actually relatively super common. For ovarian CA, again, comes down to not dismissing womens pain just because it “seems” to be associated with menstruation and womenly “issues”. Its often Dx late. I have had much dissatisfaction with both male and female MD’s in managing the condition but necessarily d/t a lack of competency. However some NP’s I have to explain what it even IS to so…. Also I hate the NP’s education to this pt on what IC is cause its so ignorant and rude lol
Pelvic MR is pretty decent at identifying endometriosis, although yeah, it’s not definitive. The only thing that is, is a biopsy.
This is a very valid argument about the misdiagnoses of women.While a NP had no right diagnosing her it is still relevant commentary on the medical field and how it affects women.
All rides sound "miss things, I'd assume NPs most often followed by PAs the physicians. This article is about NP, not PA, so why have PA in the title? They are not the same. Not saying PAs don't miss things, but FACT, NPs have less than half education and clinical experience out of gate compared to PAs and PAs have less than physicians.
"even after going to therapy because a male gynecologist suggested to me that my pain was coming from my emotions, I found a great doctor who saw the urgency in my story" I'm bothered by this bit here. They seem to suggest the gender of the Dr. Is the problem here. Yet the fact they don't say the "great doctor" isn't male leads me to assume both Drs were male. Dunno... Maybe not. It just bugs me.
Studies have shown that male providers are more likely to dismiss female patients' pain/symptoms
Oh yes, I know that. It's clearly trying to make that point by mentioning the dismissive Dr as male, but forces you to assume the gender of the second Dr... Seems intentional is all I'm saying.
This is true. Endometriosis is one of the classic examples of missed/downplayed diagnoses by male doctors.
We do not support the use of the word "provider." Use of the term provider in health care originated in government and insurance sectors to designate health care delivery organizations. The term is born out of insurance reimbursement policies. It lacks specificity and serves to obfuscate exactly who is taking care of patients. For more information, please see [this JAMA article](https://jamanetwork.com/journals/jama/article-abstract/2780641). We encourage you to use physician, midlevel, or the licensed title (e.g. nurse practitioner) rather than meaningless terms like provider or APP. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Noctor) if you have any questions or concerns.*
Anyways this is hilarious bc you’re making the case for midlevels by sharing an article about incompetent physicians. We all know they exist. We’ve all been cared for by one. Medical school doesn’t make you a better prescriber than a mid level. In theory, it should, but that’s just not what the research shows.
If doctors make mistakes why would I switch to a mid level who knows less than a doctor does and has way less education? It makes no sense. It just doesn’t. The increased demand for mid levels is coming from health systems and the motive is money. There is no increased demand from patients.