Contract Drafting Negotiation The Business of Healthcare

The Physician Assistant, No, I Mean Assistant Physician, Will See You Now

July 14, 2014

I have a woven dog, Woven Wally, a piece of art, in my Dallas office.

Obamacare provides health insurance coverage, but coverage is not access to care. For care, you need physicians and you need to be able to see a physician, the right one, when you require care.

The problem, of course, is that insurers are restricting Obamacare plan panel membership to manage access in order to stem losses, that contract rates are so low that many (perhaps most) physicians don’t want to be on the panels anyway, and that there simply aren’t enough physicians to go around: there’s a physician shortage.

The governmental solution to the physician shortage is to create more classes of “doctors” by expanding the scope of practice of physician assistants and nurse practitioners. And now, Missouri has passed a new law that allows medical school graduates who have passed licensing exams to practice primary care medicine in rural and “underserved” areas of the state. There’s no internship or residency requirement. These doctors will be licensed as “Assistant Physicians.” After a month of (real) physician oversight, they will be on their own.

In the rush to provide coverage, are we creating multiple classes of care? Completely trained physicians for some, nurse practitioners (with doctorates – “Doctor Nurses”) for others, physician assistants for yet others, and now medical school graduates (but without much clinical training) for even more?

Is this really the solution to the care shortage, to the physician shortage? Are these people, as dedicated and compassionate as they may be, “doctors” in the real sense of the word?

Is Woven Wally a real dog?

Woven Wally

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