Here is a twist of irony.
Physicians, and rightfully so, are called hypocrites, when on one hand they decry the payment system for inadequate reimbursements (and threaten patient access), while on the other, abhor solutions to remedy the same problem. Adoption of midlevels (NP’s and PA’s), which obviously are less costly, but also crowd out physicians and encroach on sacred turf is a prime example:
Representatives of the American Medical Association and the American Academy of Family Physicians said they agree with the need to expand the primary care work force. But they questioned the institute’s recommendation to expand APNs’ practice scope.
“Increasing the responsibility of nonphysician health care professionals beyond their education and training is not the answer to this shortage,”
However, a twist, today in Connecticut the governor’s office is proposing to replace nurses–which by law are the only professionals allowed to dispense prescription medication in the field, with less expensive health aides. From a Connecticut’s home care trade association representative:
Wodatch says there are serious concerns on the minds of nurses and the agencies that hire them — from affordability to liability to figuring out which patients are best suited for the change.
She described the kind of patients who would benefit from still seeing a nurse every day: “One that has changes on a daily basis, one that may have outbursts, may have significant mood swings on any given day, not be safe with a home care aide who’s trained just in giving medications and not really recognizing symptoms, side effects, interventions that could be put in place to avoid further problems.“
I just might frame this on my wall.
Bradley Flansbaum, DO, MPH, MHM works for Geisinger Health System in Danville, PA in both the divisions of hospital medicine and population health. He began working as a hospitalist in 1996, at the inception of the hospital medicine movement. He is a founding member of the Society of Hospital Medicine and served as a board member and officer. He speaks nationally in promoting hospital medicine and has presented at many statewide meetings and conferences. He is also actively involved in house staff education.
Currently, he serves on the SHM Public Policy Committee and has an interest in payment policy, healthcare market competition, health disparities, cost-effectiveness analysis, and pain and palliative care. He is SHM’s delegate for the AMA House of Delegates.
Dr. Flansbaum received his undergraduate degree from Union College in Schenectady, NY and attended medical school at the New York College of Osteopathic Medicine. He completed his residency and chief residency in Internal Medicine at Long Island Jewish Medical Center in New York. He received his M.P.H. in Health Policy and Management at Columbia University.
He is a political junky, and loves to cook, stay fit, read non-fiction, listen to many genres of music, and is a resident of Danville, PA.