There is lots of talk about a looming shortage of physicians. The aging of America is the main reason. With baby boomers entering the era of medical high usage the demand on the medical industry will be felt primarily by over extended medical doctors.
But, according to a piece on National Public Radio in November 2014, many health care experts and economists think the potential problem is exaggerated. Oh, everyone agrees that the demand will increase. The disagreement is over how to deal with it.
The Association of American Medical Colleges predicts that the country will need more than 90,000 more physicians by 2020. But health economists like Gail Wilensky believe they don't all need to be medical doctors. She believes expanding the scope-of-practice laws for nurses, pharmacists and other ancillary medical personnel would eliminate the problem.
The issue is being publicly debated by doctors and the Veterans Health Administration. The VHA has proposed to allow nurses with advanced training practice medicine without physician supervision. 6135 advance practice registered nurses, nurse practitioners, nurse anesthetists, nurse midwives and clinical nurse specialists within the VA Health Care System would be allowed to care for patients.
Doctors argue that this move would hurt a health care system struggling to care for an influx of veterans dealing with serious physical and mental issues. Nurses say it would deliver high-quality
care in a more timely manner. The American Society of Anesthesiologists said allowing nurse anesthetists to work without supervision would decrease quality of care. They believe a physician is better equipped to handle emergencies. Nurse organizations believe physicians are concerned about protecting their jobs.
Physicians contend doctors provide a higher quality of examination and consultation than nurse practitioners, who naturally disagreed, and believe their expanded role would reduce costs of medical care.
How this issue is decided within the VA system will certainly have a trickle down influence across the entire medical industry. It bears watching. I'm not sure whose position I lean toward. I have had exposure to several nurse practitioners and have found them all professional and competent. On the
other hand, I have never seen any cost saving benefit from being seen by a nurse practitioner. The "doctor bill" has never demonstrated the purported savings suggested using an ancillary medical professional would provide.
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems,
August - recovery and physical therapy, September - thinking medically, October - getting back to normal. November. -still in recovery, December-6 months and holding. 2015 January-current events.
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