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Interesting article on NP autonomy, written by an MD
- Thread starter AnnoyedByFreud
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Well the writer has two issues:
1.) His wife being a NP(which would be an obvious bias)
2.) His field of medicine is so specialized I doubt he truly knows what a PCP truly does daily.
I have no problem with expansion of scope as long as supervision is involved. If autonomy is wanted then a pathway such as a NP-Physician bridge should be created as well as NP education more standardized.
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deleted6669
And once again no mention of PAs....sigh.....at least the VA went to collaboration for all of their PAs....
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While I agree to some degree, I honestly don't think any NP, PA, MD or DO can be considered objective or not biased on this issue, myself included. For all you know, the fact that he always saw NPs as very competent and capable is what attracted him to his wife (and not the other way around). He does, at least, point out that he married his wife pretty recently but has been working with NPs for decades. I agree, though, no one is really that objective on this issue. Just look at this site, whenever the topic comes up people get very emotional and not very logical. What I found most interesting was his review of the literature on NPs. It is by no means complete, but I was surprised by the sheer number of studies that support the safety of NP practice. I also agree that the arguments docs use against NP independence are poorly constructed (some of those videos were just embarrassing), as I see that over and over again on this very site.
I also thought it was interesting how he mentioned that the AMA has much more money and power than the ANA (on this site, the ANA is often characterized as some evil lobbying group that bullies the poor, powerless doctors). That's something I'll have to look into.
emedpa - a commenter mentioned the lack of PAs in the article and the author addressed it, I believe. I think he said it was because he was talking about the specific law (which addressed NPs only) and that PAs collaborate or have a supervisory relationship with physicians by definition, so he didn't see it as relevant.
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deleted6669
emedpa - a commenter mentioned the lack of PAs in the article and the author addressed it, I believe. I think he said it was because he was talking about the specific law (which addressed NPs only) and that PAs collaborate or have a supervisory relationship with physicians by definition, so he didn't see it as relevant.[/quote]
PAs at the VA now work in collaboration instead of via supervision. this will likely spread to other federal service PAs ( see recent thread in this forum):
http://forums.studentdoctor.net/threads/new-pa-rules-va.1048281/
even for those who are "supervised" this can be without the doc ever on site and via phone or email only. some states don't even require chart review anymore, just an ongoing relationship with a physician who is available for consults.
PAs at the VA now work in collaboration instead of via supervision. this will likely spread to other federal service PAs ( see recent thread in this forum):
http://forums.studentdoctor.net/threads/new-pa-rules-va.1048281/
even for those who are "supervised" this can be without the doc ever on site and via phone or email only. some states don't even require chart review anymore, just an ongoing relationship with a physician who is available for consults.
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However isn't the article talking about NPs as "licensed independent practitioners", or states where NPs have completely independent practice, and not collaboration or supervision? Perhaps that's why he didn't mention PAs, since, although collaboration instead of supervision is great, and makes perfect sense, it still isn't the same as independence, and PAs by definition have some formal association with a physician to practice (the details of that association vary of course)? For PAs to get independent practice along the lines of NPs in those states, I'd venture to guess that they'd have to form their own boards of PA medicine, since I doubt the physicians would allow that, but who knows.
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deleted6669
Agree with your summary. I think the likely future is collaboration > supervision with maintaining a(distant) relationship with a physician.
