America is running a deficit, but it’s not the budget deficit you often hear about in the news.
No, our deficit involves healthcare providers. By 2020 it is expected that we will have over 20,000 fewer doctors than we need in order to provide quality healthcare to patients. In Pennsylvania alone, there are already over 150 areas that lack access to quality primary care. A combination of aging baby boomers as well as increased access to medical care via the Affordable Care Act, or Obamacare as some call it, means that strains will be placed on our healthcare system unlike any other it has ever seen.
It is fitting then that some are working to address this shortfall before it escalates into a crisis. House Bill 765 has been introduced in the Pennsylvania state legislature that would allow nurse practitioners to practice medicine independently, without working under a medical doctor’s oversight.
What Is a Nurse Practitioner?
It is very likely that you have been seen by a nurse practitioner in the past – whether you know it or not. A nurse practitioner, or NP, is a medical professional that is licensed and trained to provide many of the same services as a medical doctor. NPs can order tests and write prescriptions. They have a Master’s degree at the very least and many go on to pursue other advanced degrees and training.
Under most circumstances, however, an NP must get a medical doctor to “sign off” on their work. They work under the authority of the MD and generally pay the doctor a fee for the relationship.
This requirement has kept many NPs from going into practice for themselves. The vast majority of NPs work in doctors’ offices, hospitals, or other centralized health care.
Is This a Good Thing or a Bad Thing?
It depends who you ask.
Nurse practitioners and many doctors support the move because it will drastically increase overall access to health care. NPs who wish to practice privately may be able to open their doors in much the same way a doctor decides to open a new practice. The NPs of the practice would be able to see patients, make diagnoses, write prescriptions, order tests, and provide care to the general public.
At the same time, the move is opposed by many doctors, including the Pennsylvania Medical Society and the Academy of Family Physicians. Doctors cite a “fragmentation” in the team-based structure that is facilitated when doctors and NPs work together. They also do not hesitate to cite the differences in the amount of training that each professional receives during their medical training. A doctor will undergo anywhere from 12,000 to 16,000 hours of clinical training while pursuing their degree. An NP will undergo 500-700.
What Do You Think?
If given the choice between an MD and an NP, which would you prefer provide your primary care? Is there a place in modern medicine, especially given the stress that the system must operate under, for independent NPs to provide general healthcare?
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