http://www.latimes.com/health/la-me-doctors-20130210,0,1509396.story SACRAMENTO — As the state moves to expand healthcare coverage to millions of Californians under President Obama's healthcare law, it faces a major obstacle: There aren't enough doctors to treat a crush of newly insured patients. Some lawmakers want to fill the gap by redefining who can provide healthcare. They are working on proposals that would allow physician assistants to treat more patients and nurse practitioners to set up independent practices. Pharmacists and optometrists could act as primary care providers, diagnosing and managing some chronic illnesses, such as diabetes and high-blood pressure. "We're going to be mandating that every single person in this state have insurance," said state Sen. Ed Hernandez (D-West Covina), chairman of the Senate Health Committee and leader of the effort to expand professional boundaries. "What good is it if they are going to have a health insurance card but no access to doctors?" Hernandez's proposed changes, which would dramatically shake up the medical establishment in California, have set off a turf war with physicians that could contribute to the success or failure of the federal Affordable Care Act in California. Doctors say giving non-physicians more authority and autonomy could jeopardize patient safety. It could also drive up costs, because those workers, who have less medical education and training, tend to order more tests and prescribe more antibiotics, they said. "Patient safety should always trump access concerns," said Dr. Paul Phinney, president of the California Medical Assn. Such "scope-of-practice" fights are flaring across the country as states brace for an influx of patients into already strained healthcare systems. About 350 laws altering what health professionals may do have been enacted nationwide in the last two years, according to the National Conference of State Legislatures. Since Jan. 1, more than 50 additional proposals have been launched in 24 states. As the nation's earliest and most aggressive adopter of the healthcare overhaul, California faces more pressure than many states. Diana Dooley, secretary of the state Health and Human Services Agency, said in an interview that expanding some professionals' roles was among the options policymakers should explore to help meet the expected demand. At a meeting of healthcare advocates in December, she had offered a more blunt assessment. "We're going to have to provide care at lower levels," she told the group. "I think a lot of people are trained to do work that our licenses don't allow them to."
It's on the news here in California. A pretty big issue, no? The last sentence in the part of the article I quoted is damning.
Crying wolf. With Californians leaving in droves for the good life in Oregon, the population will fall to an appropriate level for the number of doctors they have there.
Maris, you forget, whatever California does, Oregon follows..come on doctor shortage, just glad I have the VA..evn if most docs are going through residency or are specializing,there are enough of them
We are eventually going to have a computer program be our doctors. Minute clinics and the like, it'll reduce costs drastically, administered by nurses, PAs, etc.
that has floated around..I dont know of any doc or PA that would risk their license by issuing an RX via comp..
I can tell you from personal experience that when people at "lower levels" are allowed to do things that are reserved for more skilled doctors the results are bad. Here in Oregon hygienists under "expanded duties" are allowed to give block injections. The incidents of permanent parasthesia (numbness) has dramatically jumped. We will stop insured all doctors with hygienists performing such procedures.
