So Rich

Bradley Flansbaum

Posted 3/13/12 on The Hospitalist Leader 

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.