The Edmond Sun

Local News

Discussion

April 21, 2010

Officials look to PAs, nurse practitioners for aid in physician shortage

James Coburn The Edmond Sun

EDMOND — Medicare recognizes Oklahoma has a shortage in primary physicians and general surgeons, said Mike Fogarty, CEO of the Oklahoma Health Care Authority. By 2011, modifications will be made in the payment system with bonuses made available to help alleviate less served areas of physician care, Fogarty said, of just one change proposed in the Patient Protection and Affordable Care Act of 2010.

At a recent health-care discussion sponsored by the Sisters of Mercy Health Care System, Mercy Health Ministries CEO Lynn Britton said the Patient Protection and Affordable Care Act of 2010 could add 20 million or more people to the ranks of those with health insurance.

Gary Raskob, dean of the OU College of Public Health, told The Edmond Sun there is a general need to increase the number of primary care physicians, especially in Oklahoma’s rural areas. Oklahoma ranks 49th in terms of primary care physicians per capita in the U.S., according to the Oklahoma State Health Department.

“We need to look whether our health-care system is adequately using all of the essentials that our professionals are trained for, and whether some of the things we historically insisted on physicians doing might be just as well done by another professional such as a physician assistant or nurse practitioner,” Raskob said.

Nurse practitioners and physicians assistants would work only in the scope of their training to provide quality health care, Raskob said.

“That requires some development of strategies for cooperation between these professions,” Raskob said. “Perhaps maybe even some legislation expanding this legal scope of practice of some of those professions so we may be able to reach more people.”

The choice may be having no doctor in a town or patients having access to another professional who works under the supervision and affiliation of a physician, Raskob said.

“I think it should be looked at because there is a serious shortage of primary care physicians out in these areas,” he said.

Raskob said the Patient Protection and Affordable Care Act of 2010 takes an innovative approach to preventative care as a means of achieving wellness. Preventive care often includes simple procedures such as vaccinations.

“A lot of that may be able to be delivered by physician’s assistants and nurse practitioners,” he said. “In the end that could potentially save us a lot of money in the health-care system because it may prevent people from becoming unhealthy and having more serious and expensive things to take care of.”

The high cost of health care is being driven by unhealthy populations with chronic conditions needing treatment, he said. These patients go to emergency rooms when their health has been neglected and their health problems have escalated to a serious degree, he said.

“When we do prevention it’s at an early stage with a more healthier person, a less complicated person,” Raskob said. “That probably could be delivered by a physician assistant and not necessarily require a physician.”

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