Wednesday, February 23, 2011

Now This Sure Seems Like a No-Brainer

"With the Texas state budget in crisis, is there anything beneficial the legislature can do that would not cost anything?  Yes, there sure is. Lawmakers can significantly improve access to health care and save their constituents money, at no cost to taxpayers.

All they have to do is add Texas to the list of 35 other states that allow advanced practice nurses to diagnose and prescribe without the oversight of doctors. The move would open the door to more retail health clinics in the state because clinic operators, such as the Walgreen Co. and CVS Caremark chains, no longer would have to pay a doctor a large fee to oversee each clinic."


7 Comments:

At 2/23/2011 8:56 PM, Blogger VangelV said...

It sounds good. We have many communities in Northern Ontario where nurses do almost all medical procedures, including many that are typically reserved exclusively for doctors elsewhere because few doctors are interested in servicing those communities. They do a better job than inexperienced first or second year doctors so I do not see the problem with them being given more responsibility given their competency level. Texas should do something similar.

 
At 2/23/2011 10:10 PM, Blogger hal said...

The problem is, we have a doctor shortage. We need more medical schools. A medical school is a business, they should be as common as any other business, and anyone who wants to study to be a doctor, should have no trouble, provided they pay their way. Whether they pass the courses is another matter.

But government cartelization of health-care won't permit an 'oversupply' of doctors.

 
At 2/24/2011 1:27 PM, Blogger juandos said...

"Yes, there sure is. Lawmakers can significantly improve access to health care and save their constituents money, at no cost to taxpayers"....

I think someone is missing the 900 pound gorilla sitting in the middle of the room...

AUSTIN — The state of Texas and local hospital districts spent an estimated $677 million to provide health care to illegal immigrants in a year, a new study says...

Dec. 12, 2008, 11:23AM

 
At 2/24/2011 5:21 PM, Blogger Dr. T said...

The decision isn't a no-brainer. I won't go to a Family Practice physician for anything more complex than influenza because these generalists all too often lack the skills needed to accurately and efficiently diagnose diseases. Nurse Practitioners have far less training and far lower diagnostic skills than family practice physicians, and they are far more likely to misdiagnose patients. That's why nannystate governments don't let them practice independently.

From a libertarian perspective, I believe that professions should not be regulated or restricted by government and that people should be able to seek care from anyone they can pay, including "naturopaths" and "crystal therapists."

From a public health perspective, allowing physician assistants, nurse practitioners, pharmacists, and (shudder) chiropracters to practice medicine is frightening. Our already high proportions of misdiagnoses and incorrect treatments would skyrocket.

Note: I'm a retired clinical pathologist (lab medical director), so I have no financial oar in this boat. I've known a few PAs and one NP who I would trust more than many family practitioners. However, I don't believe the typical NP or PA can replace a physician except for the most mundane of medical problems. I also believe that most "generalist" physicians cannot replace specialists for the more complex medical problems. As others noted, we need more physicians and proportionately more specialists. [I omit a long tirade about decades of federal government interference with medical education and training.]

 
At 2/24/2011 6:17 PM, Blogger Ron H. said...

Dr. T

"[I omit a long tirade about decades of federal government interference with medical education and training.]"

I don't know the answer, so I'm hoping you can enlighten me. How much of this government interference is at the behest of the AMA?

 
At 2/25/2011 1:26 PM, Blogger Mike said...

I live in Texas and haven't seen a doctor in years. I always go to a nurse for medication and small problems.
I guess this means they must be under a doctor's wing, but I don't see a big difference in reality. The doctor who operates the office has a few locations and only employs nurses...the doctor is never "in".

 
At 2/26/2011 9:44 AM, Blogger VangelV said...

I don't know the answer, so I'm hoping you can enlighten me. How much of this government interference is at the behest of the AMA?

The AMA is a cartel that controls the number of doctors through its monopoly on licensing physicians. If the government permitted an independent licensing body the doctor shortage problem would go away.

 

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