Pressure is mounting to allow physician’s assistants, nurse practitioners and pharmacists in California to fill a doctor shortage caused by President Barack Obama’s Affordable Care Act.
State lawmakers are proposing to let assistants treat additional patients nurse practitioners to set up their own practices, the Los Angeles Times reports.
They are also proposing that pharmacists and optometrists act as primary care providers, diagnosing and managing chronic illnesses including diabetes and high blood pressure.
State Sen. Ed Hernandez, a Democrat and chairman of the Senate Health Committee, said unless professional boundaries are stretched, expanded coverage will have little positive effect.
Doctors are generally opposed to giving non-physicians expanded autonomy, saying it could jeopardize patient safety and drive up costs, since professionals with less training may order additional tests and prescribe more medication.
California’s struggles are playing out across the country, as about 350 laws altering how certain health professionals can practice have been passed by state legislatures. An additional 50 proposals in 24 states have been floated in the past six weeks alone.
The Association of American Medical Colleges said just 16 of California’s 58 counties meet the federal government’s recommended level of primary care physicians. In addition, almost 30 percent of the state’s physicians are nearing retirement age, the highest level in the nation.
While the California Medical Association agrees health professionals should not exceed their training, physician assistants, nurse practitioners and pharmacists say they have more qualifications than existing laws allow them to use.
By Cyrus Afzali