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Physician: PAs and NPs are Minor League Providers

Published August 11, 2008 3:26 PM by Stephen Cornell

In an Erie (Pa.) Times-News roundtable discussion about health care, physician Brad Fox compares PAs and NPs to minor league baseball players:

The Senate (plan) is a lot of wishing. For them to stock the clinics they want, they have to expand the scope of practice of ... secondary providers. You'll have nurse practitioners and physician assistants staffing clinics with insufficient oversight. You'll find the standard and quality of care will decrease. You'll have more access to lesser quality care. You'll have a Triple-A team on the field when you want a major league team.

Fox is the president of the Pennsylvania Academy of Family Physicians.

With teammates like that, who needs opponents?

In the same roundtable, physician Carlo DiMarco suggests using NPs for blood-pressure screenings.

Carlo DiMarco, D.O.: It's not clear at all how the physicians would be covered with this extra cost. ... The whole system is broken. You get punished for having more patient encounters.

One response is that we can use nurse practitioners to do things like blood-pressure screenings, but they have to bill, and that gets forgotten.

Blood-pressure screenings?

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2 comments

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October 15, 2008 11:18 PM

I don't think it's any secret that there are still pompous individuals bearing the title of physician.  Even as medicine is finally being to really embrace evidence-based practice, many physicians ignore hard data on non-physician practitioners (I object to the term mid-level) as it suits their own agendas.  As far as I can determine, the evidence shows that the care provided by non-physician practitioners (PAs and NPs) is equal to that provided by physicians.  In addition, our patient satisfaction is higher.  Anecdotally, when I introduce myself in the ER...patients frequently express a preference to seeing a PA over the physician.  They also express there preferenec for seeing the PA or NP in their physicians offices as well. I can understand how those at the top of the medical food chain (physicians) would seek to maintain their position of dominance, but like many individuals who are insecure in their own sense of self-worth, many physicians would seek to accomplish this by inappropriately maligning other providers.  The evidence does not back up their assertions and therefore should be disregarded.  

Roger Best, Emergency Medicine - PA, Baghdad Embassy August 13, 2008 3:53 AM

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