More nurses taking on doctors’ duties
Nurse practitioners and physician assistants are a fast-growing force in medicine, getting paid more often for procedures people generally associate with doctors, such as electrocardiograms, pelvic exams and even helping with heart bypasses, a USA TODAY analysis of federal data finds.
Medicare billing records show 15% more nurse practitioners and 11% more physician assistants received payments in 2013 than in 2012 for all types of care. During that same year, the number of general practice physicians paid by the insurance program for the elderly and disabled dropped by 5%.
Experts say this reflects the rising influence of non-physician caregivers in a medical marketplace beset by doctor shortages and taxed by a growing number of patients gaining insurance through Obamacare. It shines light on the high-level care NPs and PAs have provided for years — and now handle far more often.
“(Critics) would say: You can’t do these procedures, and you shouldn’t do these procedures,” says Elizabeth Visone, a nurse practitioner in Connecticut. “But we were doing them.”
Among USA TODAY’s findings for 2013:
NPs billed for ER visits and cervical cancer screenings; PAs for tissue biopsies, X-rays and complicated surgical procedures. Nearly 900 PAs were paid for heart artery bypasses and 950 for spinal fusion procedures, as “first assistants” to doctors.
Medicare payments totaled $1.5 billion for nearly 65,000 NPs and $1 billion for about 50,000 PAs. Those totals were up 16% for NPs and 12% for PAs from 2012 — as payments for general practice physicians dropped 7.6%.
Each provider has a role, says Marilyn Rantz, a nursing school professor at the University of Missouri, “and Lord knows, people have enough health care needs to go around.”