Power strug­gle be­tween docs, nurses goes pub­lic

Modern Healthcare - - Special Report -

The long-sim­mer­ing strug­gle be­tween doc­tors and nurses over the na­tional patch­work of laws on nurses’ pow­ers in health­care fi­nally boils over into a pub­lic skir­mish, on the heels of a health­care re­form law that puts a pre­mium on pa­tient-cen­tered pri­mary care.

Nurses’ groups push their case in a 586-page tome from the In­sti­tute of Medicine, ti­tled The Fu­ture of Nurs­ing and re­leased in Oc­to­ber, in which the au­thors as­sert that the coun­try can no longer af­ford to let its nurses not prac­tice up to the fullest ex­tent of their train­ing. They ar­gue that nurses are quicker and cheaper to pro­duce than doc­tors, and that they make no more med­i­cal er­rors than physi­cians.

Mean­while, doc­tors, who in 2009 pub­lished their own mas­sive set of re­ports op­pos­ing changes in state scope-of-prac­tice laws, say that if the re­form law ends up push­ing lesser­trained clin­i­cians into po­si­tions of higher author­ity in medicine, the change will only fuel pub­lic re­sent­ment of the law.

Other high­lights:

Af­ter an in­ten­sive pub­lic re­view process, Bos­ton’s large Ro­man Catholic health sys­tem, Car­i­tas Christi Health Care, be­comes the largest for-profit hos­pi­tal op­er­a­tor in New Eng­land. The six-hos­pi­tal sys­tem was pur­chased in an $895 mil­lion deal by New York pri­vate eq­uity firm Cer­berus Cap­i­tal Man­age­ment. In con­trast to for-profit con­ver­sions of the past, the Bos­ton deal re­ceives wide­spread pub­lic ap­proval af­ter re­li­gious lead­ers an­nounce two of the hos­pi­tals would have to be shut­tered if they con­tin­ued to op­er­ate as is.

Ear­lier in the year, New York City loses its last Catholic hos­pi­tal when the 511-bed St. Vin­cent’s Hos­pi­tal in Green­wich Vil­lage closes down with more than $1 bil­lion in debt on its books. The hos­pi­tal, run con­tin­u­ously since its found­ing in 1849, fails to at­tract a buyer and shuts its doors for good in May.

Catholic Health As­so­ci­a­tion Pres­i­dent and CEO Sis­ter Carol Kee­han finds her­self the ob­ject of na­tional praise and scorn for po­si­tions she took in the run-up to the health­care re­form law. The CHA en­dorses the law, giv­ing Catholic Demo­cratic law­mak­ers cover to vote for it de­spite an of­fi­cial con­dem­na­tion by the

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