Plagiarizing Blackboard Discussions

I am plagiarizing myself from my leadership and health policy class, so no honor code violations have been broken! I am most excited to see that the battle is back on for eliminating the anachronistic and undermining collaborative agreement between physicians (who are educated and practice in medicine, thus have no more basis to supervise nurses than they do any other health profession they themselves are not masters of) and advanced practice nurses, many of whom have been charged thousands of dollars a year by opportunistic physicians for the privilege of prescribing within their already given scope of practice. I guess when you make the kind of money primary care physicians don't make, you have to plunder every potential revenue source you can. Nicky the Stick would be jealous. 


I will have much more to say later, meanwhile, check out the LEO article MAD Money for the spicy pre-fight analysis. 


Last year in KY, a number of state and national nursing organizations put up a unified fight to get rid of the need for physician oversight of NPs in regard to prescribing. House Bill 556 (sponsored by May Lou Marzian, an RN) and Senate Bill 75 bill were written with the intention of compromising to exclude scheduled medications. The MDs on the board put up the usual objections to "giving a bunch of nurses the same privileges as an MD," but it managed to pass in the house committee.  Documentation showing APRNs received less complaints, made greater use of KASPER to decrease narcotic "doctor shopping," and equal outcomes as compared to primary care MDs were presented. A few handshakes and some bourbon on the rocks in the back office made the smear campaign that began shortly afterward sure to get the bills  stalled - nursing may have had the greater head-count, but the MDs had more bucks. 

The good news is, the fight is back on for 2011 and the passage of health care reform (whether you like it or hate it, use what you can of it to your advantage) has put APRNs in a much better bargaining position. The shortage of primary care physicians  is not going to get filled  because the pool of medical students willing to  spend their youth and money on education with a payoff of  less than $200K/year is getting smaller and smaller. MDs should use that education to  specialize and focus on disease care and pass the baton to ARNPs for the wellness care. This is going to be a nasty fight!

Drake, S. (2010). Courier Journal. Bill to expand nurse practitioner duties advances in Kentucky. Retrieved from http://www.spapn.org/blog/?p=171 

Shaw, S. (2011). LEO Weekly. Mad medicine. Retrieved from http://leoweekly.com/news/mad-medicine 

Thomson Reuters. (2010). 2010 Kentucky senate bill no. 75, Kentucky 2010 regular session. Retrieved from  http://www.midwife.org/siteFiles/legislative/Kentucky_bill_S_75_2010.pdf