On February 4, The Wall Street Journal covered and profiled a heated discussion that is taking place in the state of Kentucky to change the law covering the ability of Physician’s Assistants (PA) and Nurse Practitioners (NP) to treat patients without having 18 months of direct supervision by a Physician (MD).
Physician’s Assistants and Nurse Practitioners argue that they are capable of treating patients without direct supervision. They believe that the occasional phone consultation is all that is necessary. Physicians are worried that phone consultation may not suffice, thus leaving them open to all kinds of malpractice problems. The Physician’s Assistants and Nurse Practitioners believe that 18 months is a long time to have to work under direct physical supervision of a physician. Currently it is the longest direct supervision period in the medical field inside the U.S. to date.
The article states that the Kentucky Medical Association’s focus is on patient safety, is disingenuous to the issue. They believe that the potential loss of income as more and more routine medical matters are handled by Physician’s Assistants and Nurse Practitioners is what might be driving the fight to preserve the law. The article also points out that the rural parts of the state of Kentucky have too few doctors already, and desperately need the additional health care coverage Physician’s Assistants and Nurse Practitioners can provide.
As the Affordable Health Care Act takes effect in 2014, we can expect more debates such as this one to surface. The medical field can expect a bulge in demand from newly insured people and any areas that are currently short staffed will feel the pressure. So in the debate over patient safety versus prolonged waiting periods, what should be done?
The medical field needs to find a common ground where Physicians can feel confident that the patient is receiving the best medical care and the Physician’s Assistants and Nurse Practitioners are able do more and reduce wait time for patients. Communication technologies besides the phone need to be considered, if not being already, as a way to bridge the gap in matters such as these.
So is there a magical technology fix? Magical, no. Practical, maybe. The best way to address this issue and similar issues is to find out what will make the Physicians feel comfortable allowing more of a free hand for Nurse Practitioners and Physician’s Assistants. If the issue is that the Physicians feel the need to see what the Nurse Practitioners and Physician’s Assistants are doing then a video based technology might be best. Something that can record patient interactions when the Physician is unavailable and allow for quick two-way video conferences as necessary.
One particular solution that comes to mind is a video based conferencing and recording system by a New York based company called Quantalytics. The company has over a decade of HIPAA experience and are experts in the video communications field with many hospitals and doctors relying on them already for their video solutions.
Could technology be the answer to a Physician shortage? No, but it might help. Technology will always be an aid to hospitals and Physicians who need to find the edge in the battles over patient to doctor ratio. The best technology is that which makes the world seem a little smaller.
Is video the answer? Maybe. The real question is can the medical field afford not to consider other secure forms of communication while this debate and others begin to heat up. 2014 is coming whether we like it or not.