Doctors at the forefront of medical care in Delco

To the Times:

This is in response to last week’s guest column in the Daily Times.

The leadership of the Delaware County Medical Society (DCMS) strongly assert that all Pennsylvania residents deserve equal access to the highest quality of medical care, which we believe involves physicians and nurse practitioners (NPs) working together. We acknowledge that nurse practitioners deliver excellent care within the physician-led team concept. Their skills are complementary to, not interchangeable with physician skills.

As physicians, we oppose dissolving the collaborative agreement between doctors and NPs due to the sheer discrepancies in our training and education. Physicians have undergone 12,000 - 16,000 hours of education and training compared to approximately 750 hours for NPs. Medical schools have a rigorous, standardized curriculum for medical students, while some NP programs are 100 percent online. We can attest to the importance of the

Our policy:

“hands-on” experience.

Residents of Delaware County overwhelmingly support physicians and NPs working together. In 2019, Susquehanna Polling and Research conducted a poll of 300 registered voters in Delaware County and found that 67% were in favor of physicians and NPs working together through collaborative agreements.

For years nurse practitioners have been stating that collaborative agreements prevent them from attracting more of their colleagues to Pennsylvania. However, according to the data that was analyzed in Adele Caruso’s article in the Daily Times last week, quite the opposite is true. According to the numbers quoted, collaborative agreements in Pennsylvania have not hampered the increase in the NP workforce, it actually grew by 25 percent in Delaware County.

Advanced practice nurses can already diagnose a patient’s illness, establish treatment plans, order diagnostic imaging studies and other tests and prescribe almost all of the same medications that physicians

Letters and guest columns are welcomed. Please include name and phone number for verification. Lengths should not exceed 400 words.

All submissions are subject to editing. prescribe. A collaborative agreement is not an impediment. It ensures that deeper medical expertise is immediately available, especially for complex medical cases. This just raises the question, why exactly are the nurse practitioners trying to get rid of collaborative agreements?

Ms. Caruso stated, “State law works against patients and nurse practitioners by adding extra steps beyond the extensive requirements of NP education and national certification.” These extra steps are in place to ensure patient safety, just as there are extra steps for physicians. Is the proposal to first eliminate collaborative agreements, and then to relax the standards that determine who is qualified to safely practice as an NP in the state? Collaborative agreements were put in place to protect our most vulnerable patients: seniors, low-income families, mentally and physically challenged individuals, physically and/or sexually abused individuals and any and all medically complex patients.

Ms. Caruso also states in her article

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610.622.8887 that other states where these rules have already passed have seen actual improvements: “Twenty-two states have already adopted this reform; their health care quality improved; access to care increased and costs decreased. “We must ask: is there data to back up that statement? For example, Arizona has not required NPs to have collaborative agreements since 2001, yet only 11 percent of all non-physicians (NPs, physician assistants, certified nurse midwives) work in rural areas and serve only 15 percent of Arizona’s rural population. A recent analysis by the American Medical Association’s Geographic Mapping Initiative shows states without collaborative agreements actually had slower growth in the number of NPs between 2013-2018, than states with collaborative agreements.

Expanding the scope of nurse practitioners has also been championed as a way to decrease health costs. But some studies have shown it may actually increase the cost of care due to CRNPs making poorer

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Letters to the Editor, 639 S. Chester Road Swarthmore, PA 19081 quality referrals to specialists, ordering more diagnostic imaging studies, and writing more prescriptions than primary care physicians.

As physicians, we care deeply about our patients’ safety. We have a duty to protect patient safety by advocating for legislation that ensures affordable access to care without compromising the quality of care. We therefore vehemently oppose Senate Bill 25 and House Bill 100. For lawmakers who truly want to address “access to care” challenges in Pennsylvania, more effective measures would include: passing legislation that expands telemedicine services; increasing state funding for physician residency training programs and increasing state funding for existing loan repayment programs for all health care professionals who serve in rural and underserved areas.

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