Last week, the Alliance For Health Reform along with the Robert Wood Johnson Foundation sponsored a discussion and webinar on the topic of Scope of Practice whose guests included our pal Dr. Reid Blackwelder, AAFP President-Elect, along with a representative of the American Association of Colleges of Nursing. You can view the full webinar above. (Also, check out my audio comments from the podcast below, or download the entire Mike Sevilla Radio Show Episode 309 here)
"Scope Of Practice" discussions are usually code for advocating for state laws to allow for more Independent Practice Nurse Practitioners, meaning that these providers can work fully independently without the need for a physician collorabative agreement that is state law in many states.
The AAFP position is that team based care through the patient centered medical home model is the ideal model. Nurse practitioners are certainly part of the care team, but the leader of this patient care team is the Family Physician. Debates in public and private forums have been happening for months.
As far as this particular webinar, both sides did delineate their talking points effectively with spirited debate. NP says that there's data stating that NP care is equivalent to FP care. AAFP states that data is not ideal, and people need to look at that data more closely. NP says they're needed in increase access to care. AAFP states that current data states that most NP goes in to specialty care and won't actually increase access to primary care.
Yesterday, a physician writing on the Kevin MD site stated, "Our primary care and scope of practice debates make no sense." While I do not agree with the entire essay, I think the general public doesn't really care about these political debates at the organization level. This in-fighing really frustrates me and other people. The best thing about this particular webinar was the last 10 minutes, in which all the panelists agreed that the larger problem is reform of this broken fee for service health care system. My hope is that more common ground can be found so that all primary care providers can focus on what's best for patient care as opposed to whose turf it is.