Tuesday, April 9, 2013
Much of the increased need for primary health care services anticipated to follow full implementation of the ACA, especially in rural areas, will likely be filled by nurse practitioners and physician assistants. Yet, restrictive state licensing regulations in many states will hamper the ability of these mid-level practitioners to fill the void. Modern Healthcare's 11th annual workforce report (subscription required) focuses on the scope of license issues facing these professionals just as their roles in providing health care could expand dramatically. The report suggest that turf wars between physicians and mid-level practitioners is at the root of some of the scope of license restrictions at issue.
This is an area where modern communication technology could really shine to provide both access to care and to ensure quality of care. As we move towards a more team-oriented approach to providing health care, either by choice or by sheer necessity, we need to be creative about remote supervision of mid-level practitioners by physicians where appropriate, and also be honest about when a physician's expertise is really needed, and when a mid-level practitioner is perfectly able to do the job. The physicians shouldn't really be worried, they will continue to be the team quarterbacks. But if the law is being used to protect the team's home turf through outdated restrictions on scope of practice, a comprehensive review of the field is needed.