Economics, Health Care, Pethokoukis

How nurse practitioners can help save US health care

Image Credit: shutterstock

Image Credit: shutterstock

It’s the oldest story in business. Large, established player tries to use government to protect itself against upstart, entrepreneurial rival. Once you begin to look for these crony capitalist power plays, you see them all around. My pal Tim Carney, for instance, has done standout work highlighting how taxi cab cartels have tried to quash Uber, the smartphone-based limo service.

Here’s another instance of such crony capitalism, with far bigger implications. From the WSJ:

Nurse practitioners in five states are fighting for the right to treat patients without oversight from doctors, as they can in many parts of the country. The battle is particularly pitched in California, where a bill that would let some nurse practitioners do their work independently passed a key legislative committee this week. California doctors strenuously oppose the idea, arguing that it could jeopardize patient safety. Other nonphysician health professionals around the country also are lobbying to expand their roles, citing the shortage of doctors in some areas and the expected onslaught of millions of patients newly insured under the Affordable Care Act next year.

US health care is an industry in desperate need of disruptive innovation. As defined by innovation guru Clayton Christensen:

Many of the most powerful innovations that disrupted other industries did so by enabling a larger population of less-skilled people to do in a more convenient, less expensive setting things that historically could be performed only by expensive specialists in centralized, inconvenient locations.

Lots of examples of this. A classic case is how PCs disrupted mainframe computers by providing convenience and good-enough capabilities. Nurse practitioners can be, if government lets them, a similar disruptive innovation. Christensen:

Take nurse practitioners and physicians’ assistants. Because of advances in diagnostic and therapeutic technologies, these clinicians can now competently, reliably diagnose and treat simple disorders that would have required the training and judgment of a physician only a few years ago. Accurate new tests, for example, allow physicians’ assistants to diagnose diseases as simple as strep infections and as serious as diabetes. In addition, studies have shown that nurse practitioners typically devote more time to patients during consultations than physicians do and emphasize prevention and health maintenance to a greater degree. But many states have regulations that prevent nurse practitioners from diagnosing diseases or from prescribing treatment that they are fully capable of handling.

This is one of the many little battles that will need to be won to bottom-up transform health care in a way that boosts value and innovation.

6 thoughts on “How nurse practitioners can help save US health care

  1. What jeopardizes patient safety is when you can’t get an appointment for six months, or the doctors aren’t taking new patients, so you wait until your condition is serious enough for the emergency room. By letting nurses take the simpler cases it will clear space in the doctors office for the more serious cases. If the doctors and their family members had the same experience of the medical profession that the rest of us have they would be more interested in improving the system.

  2. I think it’s totally depends on the urbanization and health of the peoples of that area. And it’s good if their are more nurse practitioners so that they can handle any kind of emergency situations.

  3. From a physician point of view, utilizing other health care professions will be necessary — no doubt about it. Nurse practitioners and physician assistants are already experiencing more resposibilities and will help with the primary care shortage, however, PHARMACISTS are also a good resource that can provide a lot of primary care services. The PharmD curriculum is good enough where they can provide a lot of the preventative care services and are also drug experts than can (should be able to) adjust medications as needed. Unfortunately, they are recognized by providers by CMS. A lot of reform for non-physician providers and should be providers needs to be done in order to help with the preventative medicine model that we’re going to.

    • I can’t agree more. I have worked very closely with many pharmacists and they are quite capable of helping with simple preventive care and by using POC testing they can adjust some medications. When will this tug-of-war end?

      Thanks for you great comment!

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>