State Considers Changing Non-Physicians’ Scope of Practice
California lawmakers are considering expanding the scope of practice for non-physicians in an effortÂ to address a shortage of doctors to treat individuals who will gain health insurance coverage under the Affordable Care Act, the Los Angeles Times reports.
The Times reports that only 16 of the state's 58 counties have the supply of physicians recommended by the federal government.
In addition, the Association of American Medical Colleges says that nearly 30% of California's doctors are nearing retirement age.
Meanwhile, the state is preparing to expand Medi-Cal and require most residents to have health insurance under the ACA.
LegislationÂ To Expand Scope of Practice
Sen. Ed Hernandez (D-West Covina) -- chair of the Senate Health Committee -- plans to offer legislation that would allow physician assistants to treat moreÂ patientsÂ and nurse practitioners to establish independent practices. It also would allow pharmacists and optometrists to act as primary care providers and diagnose and manage certain chronic conditions.
Hernandez questioned what good expanding health careÂ coverage is if patients "are going to have a health insurance card but no access to doctors."
Hernandez said he will introduce the legislation and hold a hearing on the matter next month.
Physicians say that giving non-physicians more autonomy and authority could negatively affect patient safety.
Paul Phinney -- president of the California Medical Association -- said, âPatient safety should always trump access concerns."
Doctors also argue that expanding non-physicians' scope of practice could increase health care costs because health care providers with less education and training tend to order more tests and prescribe more antibiotics.
Phinney said that physician assistants and other mid-level health care providers should be deployed in doctor-led teams, where they can consult with physicians while performing examinations and prescribing medications.
In an effort to address a shortage of physicians in certain areas, CMA has asked for more funding to expand participation in a loan repayment program for recent medical school graduates that provides them with up to $105,000 in return for practicing in underserved communities for three years.
Other Health Care Providers Respond
Physician assistants, nurse practitioners and other mid-level practitioners say that they have more training than they are allowed to use.Beth Haney -- president of the California Association for Nurse Practitioners -- said, âWe donât have enough providers â¦ so we should increase access to the ones that we haveâ (Mishak, Los Angeles Times, 2/9). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.