There has been some recent developments which should be of
concern to everyone. The original intent of physician asst and
nurse practioners was to work as physician extenders.
1) In some states they are lobbying to be able to set up clinics entirely
independent of physicians and state medical boards do not seem to
taking notice. This is of serious consequences to all primary care physicians
including peds,int med, and family medicine.
2) Nurse anesth are applying to work independently of attending
doctors and being granted priviledges in some states.
There are lots of people who want to pick up a prescription pad and
start writing because with prescription writing comes serious increases
in income.
3) A physician colleague told me about a nurse practioner telling
an elderly patient that " I know more then the doctor anyway" and
pt became concerned and told the hospital nursing staff.
Maybe people are not seeing the writing on the wall or the natural
progression of events but extrapolate into the future and
primary care will have competition from the very people who are supposed
to have been helping doctors.
There has been discussion about increasing the size of medical school
classes but many us students want more lucrative subspecialty fields.
Even many of the osteopathic graduates are of the same mind.
I find this situation troubling and foreboding for all those in primary care.
The most absurd unbelievable thing is that state licensing boards are willing to let pa/np set up their own independent clinic in some states but give
certain fmgs a hard time in getting a license. Read the AMA news
and write to your state medical board/local medical society to voice
your opinion and thoughts.