Are Primary Care Providers Becoming a Thing of the Past?
A lot of things about the heathcare system are broken. Economic issues and insurance-company restrictions have cut doctor's appointments to just a few minutes (7.5 is the goal for many primary care providers). Doctors are increasingly forced by administrators to comply to what's called "Pay for Performance" checklists, which take up much of the time you're paying for and depending on for your treatment. We currently have a shortage of primary care providers because of the pressures combined with low pay.
Some medical-industry insiders predict that primary care providers will become a thing of the past, replaced by Doctor-Nurses. Recent developments of "doctor of nursing practice" programs and board certifications could make it possible for Doctor-Nurses to go into medical practice - they'd be licensed to provide medical care, just like doctors.
Personally, when I go to the doctor's office or urgent care, I'm relieved when I get to see nurse practitioners. They take more time with me, ask more questions, listen to me more, and give me better information on my diagnosis and prognosis. I feel like nurses, by virtue of their training, connect more with people, while many doctors view us more as a collection of symptoms. And really, half (or more) of the time that most of us go to a PCP, it's to get a referral to someone else, right?
As long as the same directives and restrictions aren't handed down to Doctor-Nurses, its seems to me that they're the solution to the PCP problem. What do you think? Is this a good direction for the healthcare system to be headed? Do you think Doctor-Nurses would be better than PCPs, or would we run into the exact same problems down the road? Let me know what you think by posting here or in About.com's Fibromyalgia & Chronic Fatigue Syndrome forum.
Comments
I don’t see why not. We also use to have ‘midwives’ deliver babies…the Doctor-Nurses probably are more familiar with patients symptoms anyway. When I go to the Pain Clinic I don’t even see my Dr.; I see his Nurse. All the Dr. does is give me nerve blocks. I must say, though, that I feel a bit slighted by this since the Dr. is still billing for his services. But at least I get to stay longer than the average time frame.
Of course, this is only good for as long as it takes the Doctor-Nurse to realize their value and demand a raise.
I am a devotee of osteopathic medicine. The nurse-doctors are not going to be educated in osteopathic manipulative medicine. So I’ll stick with my PCP, an osteopathic-board certified internist.
Another reason you don’t see much in the way of primary care physicians as far as the number of them is because of how many people have complicated health histories. There are some people (I’ve been thru this the last 7 years before I finally went back to where I had been for 10 years before leaving for 7 years) who have a hard time finding a primary care physician to take care of just general things like colds. The reason is because of the complicated health history.
Also, I just recently had surgery on my foot and in order to get the clearance I needed to have that surgery 2 weeks ago I had to get the clearance from an actual doctor. The form required that it be from a doctor not a Nurse.
Thankfully the doctor I went to (how I finally ended up back there is a story I will spare the details on) was very helpful to me as I remembered and filled out the form right.
I got the time I needed from this doctor and also all my other doctors that care for me. I tend to have more problems with nurses depending on the situation I’m faced with than I do with doctors.
I also think if we went to a system where it was just Doctor-Nurses it would bring us right back to the problems we face now of trying to make sure that everyone is able to access medical care.
The article does “board certification”. If someone is certified, whether it’s a PCP or Nurse, would it make a huge difference if you get the same quality of care? In the case of surgery, I can understand the authorization from the physician who is performing the procedure.
I’m curious…couldn’t a PCP be a family physician, internal medication doctor or a general practioner? We’ve plenty of these in our area to select from. I sure hope it doesn’t get to the point where I have to visit my OBGYN because I have the flu.
correction - The article does mention “board certification.”