For as long as I can remember,
NPs and PAs have been repeating the mantra of "same care, less cost." I am
beginning to wonder if our some of our messages are now coming back to haunt
us. It wouldn't be the first time good intentions turned out to have unintended
When I was a student I once
discussed this very subject with my physician preceptor. I was explaining to
him how we can benefit a practice because we generate revenue without
drastically raising expenses. I remember his response. "That's communism!" he
proclaimed. "Why would you want to do that?"
At the time it sounded like a
great selling point. I mean, in those days we were paid less but we also were not
subjected to the same pressures in terms of workload and paperwork that plagued
our physician colleagues. We were given longer appointment times and often
dealt with the less complex patients.
In 2013 that is no longer the
case. Appointment times are shorter, medical complexity is higher and it is not
uncommon for many of us to be the only provider on site. We certainly do the
same paperwork and share much of the administrative/insurance headaches.
It seems we are now also facing
a physician shortage. One of the leading reasons for the shortage is that
physicians are deciding to leave practice - e.g., they are either just quitting
or retiring early. The top reasons driving the decision for MDs to leave practice
have to do with dissatisfaction. Not too surprisingly, they cite frustration
with too much paperwork, too little time to spend with each patient and not
enough pay. Sounds like "burnout" to me.
So if doctors make more than we
do and they are unhappy, how long will it be before we feel the same way? Don't
get me wrong, I think it's great to be cost effective, but have you ever asked
yourself why you would want to work as hard, get the same results, deal with
the same hassles and then get paid less? Judging by the comments I see on
various discussion forums many of us are beginning to feel just a wee bit taken
advantage of by our employers.
Perhaps it's time we re-evaluated
this particular message.