MAKING PRIVACY A PRIORITY
Roles and responsibilities are expanding for nurse practitioners and physician assistants—but not without some resistance
Reports remind providers to temper zeal for IT adoption with concern for data security
The nation’s healthcare system is said to be facing a physician shortage just as 30 million uninsured individuals are about to enter the patient pool and threaten to overload an already stressed system. The answer, say some, is better and wider use of nurse practitioners and physician assistants, sometimes called “physician extenders” or “mid-levels,” who can handle routine procedures and office visits, which would allow doctors more time to see new patients or those with more complex conditions.
That’s the theory at least, and the phrase in vogue now is to have mid-levels “practice to the top of their license.”
In practice, however, the picture is murky, as licensing requirements and scope of practice limits can vary widely, and “top of their license” can have a different definition from state to state and office to office. While the underlying desire is to maintain flexibility, no one appears eager to draw any bright lines.
In such a climate, turf wars are inevitable. The most public of these is the fight between primarycare doctors and the retail clinic industry, whose facilities are usually staffed by NPs and which recently added the management of chronic conditions onto their list of services—much to the chagrin of the American Academy of Family Physicians. But smaller battles are also likely to break out in some practices where physician compensation is based on productivity and that productivity gets diminished by a physician assistant mostly earning a straight salary.
When the American Medical Association’s House of Delegates meets next month, one of the items before it will be a resolution introduced by the Medical Society of the State of New York, which notes how the federal government and
Primary care, including pediatrics and family care, accounts for large portions of the services provided by both physician assistants and nurse practitioners.