Can a highly trained nurse deliver anesthetics as well as a physician who has specialized in anesthesiology, or does the nurse require close medical supervision? That issue emerges from two recent studies and from California’s decision last year to join 14 other states in freeing the nurses from a federal requirement that they be supervised by a physician. Colorado seems poised to join the group. The issue is potentially important to patients and to health care reformers seeking to restrain costs and reduce reliance on high-priced medical specialists.
In a snapshot of systemic waste, researchers have calculated that more than half of the 354 million doctor visits made each year for acute medical care, like for fevers, stomachaches and coughs, are not with a patient’s primary physician, and that more than a quarter take place in hospital emergency rooms.
The authors of the study, which was published Tuesday in the journal Health Affairs, said it highlighted a significant question about the new federal health care law: can access to primary care be maintained, much less improved, when an already inadequate and inefficient system takes on an expected 32 million newly insured customers?
“If history is any guide, things might not go as planned,” they wrote. “If primary care lags behind rising demand, patients will seek care elsewhere.”
I certainly hope patients seek care elsewhere, and I suspect they’re going to insist on it.
Twenty years ago I didn’t have health insurance and I made too much to qualify for Medicaid, and I needed prenatal care. I went here.
It’s a low-cost county clinic, and I got great medical care, although I rarely saw the physician.
We conducted the whole health care debate, Left and Right, on the chosen terms of the opposition, and it became all about loss and fear and scarcity, but it doesn’t have to work that way.
If 32 million new patients (and we’re now calling them “patients” or “customers” instead of “the uninsured”, they magically changed status, apparently) need access to affordable primary care and the medical industry doesn’t respond with more primary care physicians, states are simply going to look to alternatives.
That would be a great result that could speed up changes that benefit everyone.