- Joined
- Apr 12, 2006
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Although you may hear President Obama really helps out primary care specialties, you may change your mind after reading this. Some of you who used to think you are in a specialty, by virtue of your years of additional residency training beyond medical school, will soon be disabused of that quaint notion after you read this.
p461--"Authority to allow Nurse Practitioners and Physician assistants (consistent with state law) to be in charge of a patient centered medical home.'
This is a pilot program which establishes a new care model for "high need" beneficiaries. Meaning, the sickest of the sick. p462-4 describe responsibilities which could fall to NP and PA under this.
You'll like this next one.
p463
"The term 'primary care' means health care that is provided by a physician or nurse practitioner who practices in the field of family medicine, general internal medicine, geriatric medicine, or pediatric medicine."
Gee, I thought doctors practiced medicine, and nurses practiced nursing. Silly me!
Having relegated you docs in these specialties to the status of a nurse practitioner, the government creates a new specialty to take care of patients with chronic illnesses that need a doctor.
p463-4
"The term 'principal care' means integrated, accessible care that is provided by a physician who is a medical subspecialist that addresses the majority of the personal health care needs of patients with chronic conditions requiring the subspecialist's expertise, and for whom the subspecialist assumes care management. "
Who's this mean? Well, apparently not you primary care NP's, whoops, I mean primary care doctors in pediatrics, geriatrics, etc.
Having leveled the playing field between the practice of nursing and medicine, you might ask "Well then, why can't Nurse Practitioners supervise Physician Assistants?" Obama has an answer!
p480
"(3) Primary care practitioner defined--In this subsection the term primary care practitioner A) Means a physician or other health care practitioner (including a nurse practitioner) who specializes in family medicine, general internal medicine, geriatrics, or obstetrics and gynecology and...B) includes a physician's assistant who is under the supervision of a practitioner described under subparagraph A."
Lest you think state licensing laws will prevent this, think again. All the government has to do is require states to be compliant with Obamacare regulations to get federal money.
For you OB-GYNS who have labored under the delusion that your specialty isn't really, here's Obama putting your money where his mouth is.
p483
"Section 1304 Increased Reimburesement rate for Certified Nurse Midwives--Section 1833...of the Social Security act...is amended by striking "(but in no event" and all that follows through "performed by a physician")".
I'll leave it to the CNM-(MD-DO's) who subspecialize in nurse midwifery to look that up, but I think it means that you additional years of training in Obstetrics and Gynecology don't deserve a pay differential with CNMs.
I guess ya'll have to change the name of your organization from ACOG to ACOGCNM's.
Let me close this with the proverbial 'money shot'
p778 "SUBTITLE C--ACCESS--Section 1721 Payments to Primary Care Practitioners.
OK, you'll have to read this yourself...it is next to incomprehensible, which means that they are trying to cover up what it appears to mean. Parity reimbursement for Nurse Practioners who would become, by the stroke of a pen, promoted to the practice of medicine in the above discussed medical soon to be non specialties. Got that?
Oh, there's more in here, but this should give you an idea. I would urge you to read for yourself, cut, past, post, and widely disseminate this information to your colleagues, especially in "primary care" medicine.
http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf
p461--"Authority to allow Nurse Practitioners and Physician assistants (consistent with state law) to be in charge of a patient centered medical home.'
This is a pilot program which establishes a new care model for "high need" beneficiaries. Meaning, the sickest of the sick. p462-4 describe responsibilities which could fall to NP and PA under this.
You'll like this next one.
p463
"The term 'primary care' means health care that is provided by a physician or nurse practitioner who practices in the field of family medicine, general internal medicine, geriatric medicine, or pediatric medicine."
Gee, I thought doctors practiced medicine, and nurses practiced nursing. Silly me!
Having relegated you docs in these specialties to the status of a nurse practitioner, the government creates a new specialty to take care of patients with chronic illnesses that need a doctor.
p463-4
"The term 'principal care' means integrated, accessible care that is provided by a physician who is a medical subspecialist that addresses the majority of the personal health care needs of patients with chronic conditions requiring the subspecialist's expertise, and for whom the subspecialist assumes care management. "
Who's this mean? Well, apparently not you primary care NP's, whoops, I mean primary care doctors in pediatrics, geriatrics, etc.
Having leveled the playing field between the practice of nursing and medicine, you might ask "Well then, why can't Nurse Practitioners supervise Physician Assistants?" Obama has an answer!
p480
"(3) Primary care practitioner defined--In this subsection the term primary care practitioner A) Means a physician or other health care practitioner (including a nurse practitioner) who specializes in family medicine, general internal medicine, geriatrics, or obstetrics and gynecology and...B) includes a physician's assistant who is under the supervision of a practitioner described under subparagraph A."
Lest you think state licensing laws will prevent this, think again. All the government has to do is require states to be compliant with Obamacare regulations to get federal money.
For you OB-GYNS who have labored under the delusion that your specialty isn't really, here's Obama putting your money where his mouth is.
p483
"Section 1304 Increased Reimburesement rate for Certified Nurse Midwives--Section 1833...of the Social Security act...is amended by striking "(but in no event" and all that follows through "performed by a physician")".
I'll leave it to the CNM-(MD-DO's) who subspecialize in nurse midwifery to look that up, but I think it means that you additional years of training in Obstetrics and Gynecology don't deserve a pay differential with CNMs.
I guess ya'll have to change the name of your organization from ACOG to ACOGCNM's.
Let me close this with the proverbial 'money shot'
p778 "SUBTITLE C--ACCESS--Section 1721 Payments to Primary Care Practitioners.
OK, you'll have to read this yourself...it is next to incomprehensible, which means that they are trying to cover up what it appears to mean. Parity reimbursement for Nurse Practioners who would become, by the stroke of a pen, promoted to the practice of medicine in the above discussed medical soon to be non specialties. Got that?
Oh, there's more in here, but this should give you an idea. I would urge you to read for yourself, cut, past, post, and widely disseminate this information to your colleagues, especially in "primary care" medicine.
http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf