Governor's Health Care Remarks Spark State Society Response
On Dec. 11, 2006, Governor Ed Rendell spoke to the press about his plans for reforming Pennsylvania's health care system. Top priorities during his second term include expanding access to care and reducing the state's health care costs.
One of the governor's proposed cost-cutting measures—giving nurse practitioners freedom to perform more tasks—led the Pennsylvania Medical Society to respond.
Following is a statement from Mark A. Piasio, MD, MBA, president of the Pennsylvania Medical Society and a practicing orthopedic surgeon from DuBois, PA.
Recently, Governor Rendell made brief comments on future plans to reduce health care costs by expanding the scope of practice of nurse practitioners. The Pennsylvania Medical Society will carefully review the Governor's plan once the details are made public in January.
Physicians now work in collaborative teams with nurse practitioners, physician assistants and other caregivers. Allied health practitioners can help with problems of access, but there needs to be appropriate accountability and supervision.
The Pennsylvania Medical Society supports the appropriate use of allied health practitioners as part of collaborative health care teams, including nurse practitioners. Quality of care and patient safety are paramount.
The Medical Society encourages the collection and analysis of additional data to support the contention that expanded scope of practice will reduce overall costs. A full study should include the financial impact that use of practitioners will have on utilization and frequency.
Overall, efforts must be made to safeguard against further fragmentation of health services and breakdown in coordination of medical care.
Excerpts from Governor Rendell's comments to members of the press
The following excerpts were taken from a report by Capitolwire.com news service.
Q: How do we cut health care costs?
Rendell:
Well, I’ll give you one example. For example, we should employ nurse practitioners in the delivery of health care services far more than we do.
It’s estimated by academics that a nurse practitioner can perform about 70 percent of the things that a primary care physician can do, as well as 80 percent of what a pediatric primary care physician can do. And they do them for often 50 percent or less of the costs.
So why don’t we do that in Pennsylvania? Because the things that nurse practitioners can do are often limited by regulation or statute.
I want to free nurse practitioners to virtually do anything they are capable of doing. Unlock all of those regulations, all the restrictions, and put them back into the game.
I don’t know if many of you followed it, but I did a press conference at a Walgreens in Beaver County, where a private company is putting in these big-box Walgreens, a nurse practitioner clinic where citizens can go in and get non-emergent care.
Often the same care that citizens go to emergency rooms to get, because they don’t have a primary care physician or they can’t afford it, etc., and even if they’re Medicaid [recipients], a nurse practitioner can give them an inoculation, a flu shot, well that’s again 50 percent of the cost of going to a doctor for a flu shot.
So we ought to be doing that.
We ought to have in every emergency room in the state, we ought to have a second room for non-emergent care.
I always give the example: you’re playing with your dog and your dog accidentally bites you on the webbing of your hand. You’re bleeding and you can’t stop the bleeding. If it happens at 10 at night or two o’clock in the morning, you have to go to an emergency room. You go to an emergency room and it’s busy, they’ll give you a piece of gauze and say, “Keep the pressure on,” and maybe they’ll see you four-and-a-half hours later.
Why?
Why not have a second room, staffed with nurse practitioners who look at that, put mercurochrome on it and stitch you up – at 40 percent of the cost of getting a doctor into an emergency room to do it?
Why can’t we do that?
One, there are none of those rooms available. But, two, nurses cannot give stitches, cannot do stitches in Pennsylvania outside the presence of a doctor.
They can do it if a doctor’s in the room, but they can’t do it outside the presence of a doctor.
Why?
Last Updated: 7/31/2008