Doctors to Lawmakers: Remember, People Like Us

Physicians look to leverage their popularity amid contentious debate over nurses.

Dr. Martha Perez examines Maria Lebron in a room at the Community Health of South Florida, Doris Ison Health Center on February 21, 2013 in Miami, Florida.
National Journal
Sam Baker
Dec. 18, 2013, 9:46 a.m.

Fam­ily phys­i­cians have a mes­sage as Con­gress and state le­gis­latures con­sider a range of policies that would squeeze doc­tors’ pay: People still want their doc­tor in charge.

There’s a short­age of primary-care doc­tors in the U.S., and de­mand is about to surge be­cause of the cov­er­age ex­pan­sion in the Af­ford­able Care Act. As a res­ult, many states are con­sid­er­ing meas­ures that would let nurses and nurse prac­ti­tion­ers take on more re­spons­ib­il­ity.

But the Amer­ic­an Academy of Fam­ily Phys­i­cians says that’s not the an­swer—and that pa­tients won’t like it, either. Ac­cord­ing to a new sur­vey that AAFP com­mis­sioned, 72 per­cent of Amer­ic­ans say they want to see a doc­tor for their med­ic­al care, com­pared with just 7 per­cent who say they want to see a nurse prac­ti­tion­er.

AAFP’s sur­vey says people rate nurse prac­ti­tion­ers highly on at­trib­utes like be­ing “com­fort­ing” and “a good listen­er,” but rate doc­tors high­er on “who I want to see when I am sick.”

AAFP Pres­id­ent Re­id Black­weld­er said it’s “very en­cour­aging to have af­firm­a­tion” of what primary-care doc­tors already be­lieved—that they’re the ones people turn to and want to con­tin­ue to turn to.

Nurse prac­ti­tion­ers re­leased their own com­pet­ing poll last month, in which 62 per­cent of re­spond­ents said nurse prac­ti­tion­ers should be able to provide cer­tain ser­vices—such as writ­ing pre­scrip­tions and or­der­ing dia­gnost­ic tests—without su­per­vi­sion from a phys­i­cian.

The battle between nurse prac­ti­tion­ers and phys­i­cians is play­ing out ahead of a surge in de­mand for health care, with as many as 30 mil­lion people ex­pec­ted to come in­to the sys­tem through Obama­care. Primary care isn’t an es­pe­cially luc­rat­ive spe­cialty in the first place, and Black­weld­er said res­id­ency op­por­tun­it­ies for primary care will be in short sup­ply in just a few years.

“The work­force is­sue is huge,” he said.

In­stead of boost­ing nurse prac­ti­tion­ers’ role, AAFP wants law­makers to ad­dress the doc­tor short­age by fund­ing more res­id­ency pro­grams in primary care and in­creas­ing doc­tors’ pay­ments un­der Medi­care and Medi­caid.

But those pri­or­it­ies are all wait­ing in line be­hind a per­man­ent “doc fix,” Black­weld­er said. He said Medi­care’s pay­ment for­mula for phys­i­cians is the single biggest threat to primary-care doc­tors. AAFP sup­por­ted this year’s bi­par­tis­an, bicam­er­al push to per­man­ently re­place the for­mula, which calls for pay­ment cuts that Con­gress routinely delays. That ef­fort didn’t make it across the fin­ish line this year be­cause law­makers couldn’t agree on a way to pay for a per­man­ent fix.

What We're Following See More »
TWO-THIRDS
Voters Want Medical Records
10 hours ago
THE DETAILS

Even though they dislike both of them, the American people want to know that its presidential candidates are healthy. "Nearly two-thirds of registered voters think presidential candidates should release details about their medical histories, according to a new Morning Consult poll." In the new poll, 64 percent of Americans say the candidates should release their medical reports, up nine percent from May.

Source:
OPTIMISM ABOUT STATE OF ECONOMY
Yellen Paves Way For Interest Rate Hike
11 hours ago
THE DETAILS

In a speech Friday at the Federal Reserve's Jackson Hole summit, Fed chair Janet Yellen sounded an optimistic tone about the state of the American economy, before implying that a hike in interest rates is on the horizon. The Fed "continues to anticipate that gradual increases in the federal funds rate will be appropriate over time to achieve and sustain employment and inflation near our statutory objectives," Yellen said in her address.

Source:
10 CASES
Study Finds Little Evidence of Voter Fraud
11 hours ago
THE DETAILS

While politicians argue over whether or not to be worried about potential voter fraud come November, a study tells us it is not a legitimate concern. "A News21 analysis four years ago of 2,068 alleged election-fraud cases in 50 states found that while some fraud had occurred since 2000, the rate was infinitesimal compared with the 146 million registered voters in that 12-year span. The analysis found only 10 cases of voter impersonation, the only kind of fraud that could be prevented by voter ID at the polls."

Source:
PROCEDURES NOT FOLLOWED
Trump Not on Ballot in Minnesota
1 days ago
THE LATEST
MOB RULE?
Trump on Immigration: ‘I Don’t Know, You Tell Me’
1 days ago
THE LATEST

Perhaps Donald Trump can take a plebiscite to solve this whole messy immigration thing. At a Fox News town hall with Sean Hannity last night, Trump essentially admitted he's "stumped," turning to the audience and asking: “Can we go through a process or do you think they have to get out? Tell me, I mean, I don’t know, you tell me.”

Source:
×