A recent blog post by the American Enterprise Institute states that the increasing number of citizens with health care coverage under the Patient Protection and Affordable Care Act may produce problems for the projected physician shortage in 2020:
30 million Americans currently without health insurance will be getting coverage next year. But by 2020, there’s a projected shortage of 45,000 primary care physicians.
This seems like a big problem. But there is an obvious solution: Give more autonomy to nurse practitioners. As this AARP blog post points out, “the American Association of Nurse Practitioners [have] 43,000 members who say they can offer basic care if state laws would just let them set up an independent practice without doctor supervision.”
Nurse practitioners working in retail clinics — such as those at Walmart, CVS and Target – can offer care as good as or better than what doctor’s offices provide — at about 40% lower cost.
Half of the states allow nurse practitioners to diagnose and prescribe independently without any physician involvement, but the other half don’t. For the good of the patient, those states try to leave care in the hands of doctors.
So for simple disorders, retail clinics offer much higher quality of care than a doctor’s office, but because doctors have such political clout, they just fight these retail clinics tooth and nail.
If nurse practitioners provide quality care in a more cost-effective manner without laws that require physician supervision, physicians will be able to focus on patients requiring more intensive care. This will certainly mitigate the doc shortage crisis.
The collaboration of physicians and advanced nurse practitioners is critical to guarantee patient protection, but black letter law is unnecessary to dictate the rules of medical practice amongst these medical providers.
