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Culture War Roundup for the week of November 18, 2024

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I'm going to push back on the assumption that nurse practitioners, or even registered nurses, tend provide worse care than doctors for most patients. I want something more than an impression of anecdotes--preferably actual studies--because in my circle complaining about getting misdiagnosed made by doctors is a well-honed pastime.

I dig your take that those born to the PMC class who strive for Doctor status don't downgrade to nursing. In my experience, nursing Bachelors programs are still very competitive, and there are plenty of children of PMC that go into it (heck, I know a few). These are young women (for the most part) who like to work with people, who like clearly meaningful work, who are not put off by the prospect of hard work, and who by-and-large aren't strivers.

Nursing Bachelors programs also draw plenty of (mostly) women from the working class--because it's clearly meaningful and hard work that's well-renumerated--and only the smartest and most conscientious tend to make it into--and then through--the competitive Bachelors.

It therefore seems to me that there is a positive selection for a combination of conscientiousness, intelligence, and willingness to work hard. So without looking more into the data on the subject, I predict that a study comparing rates of misdiagnosis would be similar for Nurse Practitioners and Doctors, and probably not much worse for Registered Nurses.

Especially if the study counts the final diagnosis of the system rather than the initial diagnosis: a good Registered Nurse can look at a first-time patient, say "I think it's anxiety, but since I am not certain, so please wait while I consult with the Doctor on staff", and that may be the right call when the Doctor then identifies it as a blood clot. A good diagnosis by Registered Nurse should be "I know it's this" or "I need to send it up the chain of specialization".

(My thanks to @ToaKraka for posting earlier the info on what various nursing type professions require.)