Tuesday, March 26, 2013

Health Policy Observations

My apologies in advance for this post as I'm sure it is a bit all of the place. I wanted to just jot down some of my thoughts on the "nurse practitioner vs. physician debate." There has been many articles recently written about this, so here are my thoughts: (these of course are my own thoughts and not representative of my affiliations)

  • Above all else, nurse practitioners want to practice at the "top of our licenses." That is, to our full education and training. Imagine having access to the most wonderful car in the world - that can not only take you to wherever you want to go, in great comfort and with with excellent gas mileage, but not having the keys to start it. That is the restriction of the collaborative agreement. NPs have the education and training to care for patients in their specialty. However, without a collaborative agreement with a physician, we can't use any of it. We are stuck in the proverbial parking lot without keys. 
  • Nurse practitioners DON'T want to replace or supplant any profession. Yet inherently, there is the insinuation of NPs "taking over" or "replacing" others. I guess I would be defensive if someone told me that I would be replaced by someone else too. 
  • Yes, we all get that physicians have more hours of training.
  • I laugh at the pilot and flight attendant analogies. 
  • We are not the enemy.
  • Collaboration is not a dirty word. I refer back to my post written nearly five years ago, Collaboratus. Working together in the interest of the patient. Novel concept? It shouldn't be. 
  • I really laugh at the "if you want to be called doctor, then go to medical school." I haven't heard that one before. 
  • When NPs practice, physicians aren't in the room watching over them waiting for them to make a mistake or miss something.
  • Who "owns" quality of care? Every single licensed provider has a vested interest in the quality of care they deliver. With more and more available data points, patients will judge and decide who provides their care. 
  • Decreased costs. There is an assumption that since NPs are paid less than physicians, then costs should go down. My counter for pay parity: patients are receiving treatments (with similar or higher quality) and THAT will decrease costs.
  • NPs can only take care of "simple" things. Not true. No condition is simple. We treat patients, not conditions. Nothing is simple and we recognize and understand that as we partner with our patients.  
Please no more "us vs them." Stakeholders far and wide agree, that the way we provide healthcare in this country must change. It will be much better for all involved if we go at it together. Ok, I feel a little bit better now.

3 comments:

Anonymous said...

Stephen, Thank you for addressing this issue. The time to promote NPs is right now. The public needs to have the facts before organized medicine feeds them poison...and they will! Start a widespread campaign to portray what the NP will do for healthcare in America.

NPs Save Lives said...

I agree with every point that you made. There is no merit to the argument that we are trying to take away the doctor's jobs. For one reason, where are they? My CEO cannot find a family practice physician to work in our small town! I've been there for going on 6 years now and have not ever had my boss second guess any of my decisions. If I'm not comfortable with a problem, I have no problem consulting with my collaborating doctor and they often ask my opinion as well. I think the problem is mostly the older docs who don't really understand what we are capable of doing in medical practice.

marianna crane said...

I have heard the statement about "let nurses go to medical school" since I first graduated as an NP in the early 80s. Organized medicine over the years has been telling the public that health care services from NPs are only safe with physician supervision. Enough is enough.

I don't think competition is a dirty word. Check my latest post on nursingstories.org.