As the Affordable Care Act brings health benefits to millions of newly insured Americans, a potential physician shortage means primary care will be delivered by and prescribed by more than just doctors.
This means nurse practitioners, physician assistants and pharmacists will take on a greater role in working with doctors and, in some cases, taking on their role as prescriber of prescriptions and other medical care–all in the name of keeping patients healthy and out of more expensive hospital settings.
In the new ebook, Inside Obamacare: The Fix For America’s Ailing Health Care System, I look at ways drugstore chains like CVS/Caremark, Walgreens, Wal-Mart and other retailers are trying to expand the role of nurse practitioners, physician assistants and pharmacists, and the tension that is arising when that happens.
For this to happen at all, states are going to have to ease scope of practice laws to allow non-doctors to perform more functions, the book shows. Naturally, doctors are resistant to these efforts.
For nurse practitioners, states regulate the procedures and care that nurses provide even though they pass national standards and board certifications. Nurse practitioners and pharmacists often have to battle powerful doctor lobbies to change these laws in state capitols across the country.
Presently, 17 states and the District of Columbia offer patients full and direct access to nurse practitioners, while the rest have regulations that restrict access to nurse practitioners.
“Among states that limit patient access to nurse practitioner services, the most common barrier concerns prescriptions,” Kenneth Miller, co-president of American Association of Nurse Practitioners, says in the book. “It is far too common for nurse practitioner patients to face challenges obtaining pharmaceuticals, diagnostic tests, medical equipment, etc. because of needless state restrictions that deny nurse practitioners the authority to write these ‘scripts.’ This results in delays, increased costs and disparities in health services and access.”
Prescription usage remains on the rise with anti-hypertension, pain and mental health drugs among the most prescribed. But supporters of a more coordinated approach to health care say it’s less about the increase in prescriptions as in compliance by patients who aren’t taking their medications.
Walgreens, for example, has formed various affiliations with larger hospital systems like Ochsner Health System in New Orleans and Johns Hopkins Medicine in Baltimore to create patient care protocols and other programs so physicians and pharmacists are in sync, reconciling what medications a patient is on, and ensuring the right pill regimens are taken.
Forbes E-guide: "Inside Obamacare" Appears At Care Coordination And Better Prescription Use
