Not So Fast

A few weeks ago I highlighted how the AMA came out with a position statement declaring health care teams should be led by physicians.   Take a look at the post here.  It seemed reasonable.  It seemed logical.  The editorial even pointed out this information:

In March 2012, Virginia instituted a first-of-its-kind law that can serve as a model to other states on how to formally recognize physicians’ role in leading health care teams, and the abilities of other professionals to deliver care up to the standards of their training. The law specified that nurse practitioners must practice as part of patient care teams that are led by physicians. The law also increased from four to six the number of NPs an individual doctor may supervise, and removes a requirement the NPs and the doctors regularly work at the same location, giving the option of using telemedicine to collaborate. The result is that access to care is expanded, particularly in underserved areas, in a safe and effective way. The AMA plans to use the Virginia law as a template to develop model state legislation.

That law, by the way, was hammered out with the state NP group being involved.  It was a long and tedious process. “The Medical Society of Virginia and the Virginia Council of Nurse Practitioners collaborated for nearly two years on the effort. In doing so, they found that they were able to work toward common goals, said Michael Jurgensen, the society’s senior vice president of health policy.”

I ended my 1/21 blog by saying, ” Is this heresy to state that physicians should lead?  I am sure there are a lot of midlevel organizations that are pissed right now.”  Well, I was right.  Here is what Angela  Golden NP, president of the American Association of Nurse Practitioners, said about the AMA statement:

Regarding “Health care teams must be led by physicians”: Your editorial reflects a point of view that is out of step with new and evolving health care delivery models, and the current and future health care needs of the country.

The overlapping and complementary skills of today’s diverse range of health professionals make hierarchical, physician-centric structures unnecessary. In fact, they hinder health care access, a major issue as states look to address the shortage of primary care providers and simultaneously prepare for increased demand for health care services stemming from implementation of the Patient Protection and Affordable Care Act.

Instead of seeking to maintain the status quo, the American Medical Association and other leading professional associations should support efforts that empower health professionals to practice to their full potential and put patient care needs first.

Out of step with new models?  Remember, they agreed to the Virginia law.   This editorial just shows that they, as a group,  DO NOT believe that doctors should be higher in the hierarchy.  And that is extremely important.   To be fair, this is the just the NP organization talking and not the PAs (who are much better about this).    I also love how they once again use the shortage of primary care doctors as a way to claim they have equal ability to treat.  They are hijacking this crisis just to further their own cause under the guise of putting “patient care needs first”.

So, I am the bad guy for bringing up how nurse practitioners want to compete and not just collaborate?   They are offended that the AMA thinks doctors are on top of the medical chain but I can’t push back on this without being accused of some type of discrimination because I use the term LELT?  Child, please.   That editorial by Angela Golden could have eased a lot of fears by being more appeasing (they did agree to the Virginia law) but instead she did exactly what I have said the NPs have been doing all along.  I, for one, won’t give up the fight.

29650cookie-checkNot So Fast