A Sign of Things to Come

This is a little old but still worthy of mentioning:

At least 15 physicians have been fired from Edward-Elmhurst Health as the suburban Chicago-based health system moves to cut costs, sources told MedPage Today.

The doctors, who worked across its seven “Immediate Care” or urgent care sites, will be replaced by advanced practice nurses, according to an email sent by hospital leadership that was shared with MedPage Today. The physicians were informed late last week that they would be terminated as of April 1, 2020.

The article also referenced some more changes elsewhere:

  • Last year, 27 pediatricians at a chain of clinics in the Dallas area lost their jobs and were replaced by nurse practitioners — even though the chain subsequently changed its name to MD Kids Pediatrics.
  • Also in 2018, Charlotte, North Carolina-based Atrium Health ended a nearly 40-year contract with a 100-member physician group, signing up instead with Scope Anesthesia, which says it’s dedicated to forming partnerships with certified registered nurse anesthetists. Atrium said it too was looking to reduce patient costs.

Thoughts? Do doctors deserve this because they let it happen? Do patients have the right to know they are NOT being treated by a doctor?

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A Collaborative Work From Some of the Writers at Authentic Medicine

These editorials are from some of the writers here at Authentic Medicine. The opinions expressed by these authors do not necessarily purport to reflect the opinions or views of other writers of this blog. Each collaborative work may, in fact, be from different authors.

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2 Responses

  1. Kay Victor Adamczak says:

    As a patient, replacing qualified physicians with unsupervised non-physician personnel concerns me greatly.
    Having had bad experiences and outcomes with NP’s and PA’s makes me distrust their capabilities and refuse their care.
    Personally, I feel it would be unethical and deceptive not to inform a patient they are not receiving care from a qualified physician. Not to do so flues in the face of informed consent.

  2. JRDO says:

    Did local retail stores deserve to die when Walmart came to town?
    Do large brick and mortar stores deserve to die because Amazon.com has revolutionized home shopping?
    As long as healthcare is similarly treated as a profit-oriented industry, the business suits will keep cutting costs and the consumers will keep choosing the less expensive options.

    Ya’ll think that “free market” can save PCP jobs?
    Guess how many patients Edward-Elmhurst will choose to go elsewhere because the physicians have been replaced by PA/NPs. It’ll be negligible if any.

    And let’s stop pretending that it’s just the business suits. The majority of private practices in my area include PA/NPs- because it increases profits. This is a dog-eat-dog turf battle where many physicians are slowly killing their chosen profession because of their own economic interests.

    The only effective way to fight this turf battle is through government rules. However none of our organized groups (AMA, ACP, FAFP, state medical societies, etc) have shown any interest in lobbying for such rules and some of us reflexively view any government involvement as horrific.

    Summing it up:
    1) many private practice physicians are promoting PA/NPs,
    2) medical organizations don’t advocate for limiting PA/NPs,
    3) some physicians who don’t use PA/NPs have the notion that the turf battle can be fought with the “free market”.

    “We have met the enemy and he is us”- Pogo

    IMO the long range forecast for PCPs doing hands on care is bleak except for niche practices like DPCs.
    It won’t take long before most Primary Care Physicians primarily have a supervisory role
    – the same way that a single anesthesiologists currently supervise multiple ORs each with a CRNA
    – the same way single hospital floor nurse supervises multiple CNAs rather than directly take of patients.
    – the same way a single physical therapist supervises a cadre of physical therapy assistants

    Whether or not you think this a good or bad thing will depend on your priorities. It can be argued either way. Personally, I am comfortable where I’m at and will continue to spend the remaining years of my career the old fashioned way without the use of a PA/NP.

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