Skip to main content

The Solution!

Medgadget recently had the opportunity to interview the president-elect of the AMA, a cardiologist. Someone obviously with the finger on the pulse of primary care. One of the hot topics that he was asked about was the bleak outlook on primary care. This is from the interview:

Q: Here's a question from one of our editors, Nick Genes. He's a resident of emergency medicine at Mount Sinai in New York. Many pundits and experts believe that the US government will improve access to primary care (one way or another) in the next 2-5 years. The Massachusetts experiment suggests there will not be enough primary care doctors to cover the increased demand. Already, primary care doctors are overworked and under compensated, with many leaving the field or choosing specialty training instead. How is the AMA planning to respond to this challenge?

A: ... We continue to mention the importance of trained primary care, and I should also mention the AMA created the scope of practice partnership, because our concern is, that there are those who would rather have the nurse practitioner become the primary care physician. And we don't believe that's fundamentally fair for patients to try and say that a nurse practitioner is the same as a well trained physician who's undergone post graduate training in the practice of medicine.

For those of you unfamiliar with the "scope of practice partnership(SOPP):" is a collaborative effort within the House of Medicine to focus on the resources of organized medicine to oppose scope of practice expansions by non-MDs/DOs that threaten the health and safety of patients.

So the AMA's solution to respond to the challenge of physicians leaving primary care is to denigrate NP practice. I think most NPs acknowledge the fact that we aren't the same as physicians and use that difference as our distinction - we synthesize nursing and medical care. We NPs aren't the only targets here - optometrists, podiatrists, nurse midwives and chiropractors are among other professions that also make the list. In fact, 35 professional organizations formed a joint statement and launched the website, Coalition for Patient's Rights to offer a counterpoint to any inaccurate or misleading information.

The SOPP organizations are also prepared to put their money where their mouth is. It is estimated that at the onset of this movement in 2006, they had a minimum of $470k at their disposal and no less than $300k each additional year. That is a lot of money that doesn't do much to help the single mother without health insurance. Again, this is all under the guise of "protecting the health and safety of the public."

To put those dollars in perspective, my recent post on Remote Area Medical (RAM) operates on a budget of $250k/year and treats about 17,000 patients. Unfortunately, they must turn away thousands of patients since they simply cannot meet the demand.

Sadly, this is another example of creating further barriers to access healthcare. Precious resources are being wasted in this campaign that tries to portray NPs (and other health providers) as being part of the problem in healthcare.

This is the solution? Really?!?

Comments

Anonymous said…
-Not surprising that that the AMA would take this position since they are an organization whose mission is to protect the interest of MD's. However, in my experience Primary MD's and many specialists "in the trenches" support and value the NP role.

Patients are better informed then he suggests and know there's a difference. It's not the patients who need to be enlightened.

Thanks for posting this info.

Popular posts from this blog

Private Practice

There is an interesting trend that I'm observing and don't necessarily see how this is going to turn out. I'm seeing more and more nurse practitioner's opening their own autonomous practices. Many of these offices set out to offer care that is personalized, covered under insurance, and of course high-quality. I'm also seeing more NP specialty/sub-specialty practices such as house calls, incontinence, and women's health. This is in a time when more physician practices are joining together in these conglomerations that aren't necessarily tied to hospitals. You'd be hard pressed to find a solo primary care physician these days yet nurse practitioner solo practices are popping up. The talk about the formation of accountable care organizations can be attributed to health care reform and the spurring of large multi-physician practices. What to make of this? I honestly don't know. Many people and patients have said to me "you should start your own prac...

NP Residency

The healthcare system of today is so complex yet so dysfunctional that I believe the time has come to educate and train the NP providers of tomorrow in a way that is reflective of that complexity. We have done a good job up to this point but need to bring that to the next level. Residency. I'm not necessarily referring to the typical residency training of physicians which takes place in hospitals but a residency-type of program in an out-patient setting (ironic that we use the term residency). We realize that healthcare is not exclusively delivered in hospitals. It takes place in independent providers offices, in community health centers, in mobile health vans, and in retail settings. It takes place in people's homes and places of employment. It takes place in many of the health decisions that we make on a daily basis. I found this NP residency program in Connecticut that claims to be the first NP residency in the US. The programs admits 4 NPs each year and trains them to ha...

Precepting Students

I've precepted many NP students during the years and usually had pretty rewarding experiences. (There was that one student that just didn't get it...I guess I can save that one and how I handled it for another post!) I like to think of precepting as a two-way street: my student is getting the hands on experience of patient care with guidance while I can further hone my precepting skills. Precepting a student is not simply telling them how to treat a condition or how to prescribe a medication. It is helping that student critically think to formulate differential diagnoses and treatment plans. Precepting can often be overlooked as part of the education and training of health professionals yet it is a critical part of acquiring the necessary skill set of patient care. I think back to my experiences as a student and have found supportive clinicians that helped to shape me into the clinician I am today (I was precepted by a Doctor of Osteopathic Medicine, an OB/GYN, a family nur...