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Dilemma: Millions more Californians getting covered by health insurance, but not enough physicians to treat them – outlook especially bleak in the Central Valley. Potential remedy: Scale back regulations and allow folks like pharmacists, physician assistants, nurse practitioners and optometrists to act as primary care providers – to do things outside their current “scope of practice.”
That hot button is currently being pressed by lawmakers in Sacramento and other parts of the country, setting off what the Los Angeles Times called a “turf war” with the physician establishment.
State Sen. Ed Hernandez, an optometrist, said he would introduce legislation giving more authority to folks like him who encounter patients who are clearly diabetic but are not allowed to diagnose or treat those patients. He must refer them elsewhere – to either wait for care or allow their symptoms to advance untreated.
The head of the California Medical Association, Dr. Paul Phinney, a pediatrician, told the Times that giving more power to non-physicians was the wrong tack to take. “Patient safety should always trump access concerns,” he said, suggesting less-educated caregivers might overprescribe or order inappropriate tests, driving up costs. Instead, he recommended that more funding go to a loan repayment program for recent medical grads who agree to practice in underserved areas.
It can take a decade or more to educate a physician. The demand for care is right around the corner. As longtime Valley resident and current head of the state Health and Human Services Agency Diana Dooley was quoted as saying in the Times: “We’re going to have to provide care at lower levels. I think a lot of people are trained to do work that our licenses don’t allow them to.”