Most primary care doctor’s days are busy. Seeing patient after patient, they try to provide the most patient-centric, evidence based care that they can. But with the new healthcare reform, doctors tell me that 80-85% of the patients they see can be seen by a nurse practitioner or a physician’s assistant. “So why did I train for an extra 3-4 years as a doctor, incur several hundred thousand dollars in debt, and go through years of residency training to do the same work as someone who has done a fraction of this?” as one doctor said.
The Affordable Care Act is already changing medicine – If nurse practitioners and physician assistants can see 80-85% of the patients a primary doctor can see, and require only 4 or 5 years of post-graduate training – and not the 7 or 8 that most primary care physicians receive – then we need to develop systems that select the 15-20% of patients that need a physician. As one doctor noted, “Primary doctors are going to be overwhelmed not only with the 30 million new patients that now have insurance but with all the free screenings doctors will now have to preform at no cost.”
In the future, medical groups will need a mix of Physician Assistants, Nurses Assistants, and MDs, break down their job responsibilities, descriptions and levels of care in order to separate the 15-20% of the people that are sick and really need a doctor. Not doing this is a systems failure with broad implications for patient and provider satisfaction, healthcare spending, access to care, and healthcare reform.
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