Some people are concerned that recent health care reform legislation will improve access for people and result in a deluge of patients into doctors’ offices.
We’ll see if that materializes. It may be those patients are being seen already as uninsured patients who are receiving poorly coordinated care in a variety of settings — including emergency rooms and hospitals. It may be that that improving their access to care will result in some effiencies. We have to wait and see.
But if the deluge materializes, there could be changes to who cares for patients. Already there is growing use of physician extenders — nurse practitioners and physician assistants — to help care for patients. A recent Wall Street Journal article suggests that another option will be to expand the scope of health care services offered by pharmacists.
The relative monopoly that medical doctors have in providing health care services is gradually eroding. Some people think this is a horrifying prospect. I’m not so sure. Clearly, there are some important advantages of having health care given by a well-trained medical doctor. But there are limitations as well. To the extent that physicians can supervise, manage and guide treatment using other caring health care professionals, I think our health care system and our patients will be well served.