Thursday, April 28, 2005
Shifting care from physicians to nurse practitioners do not result in any cost savings
"Because nurses spent more time with each patient, however, they saw fewer patients per hour. In four of five studies on nurse-led urgent care, lower salary costs were offset by this so-called 'lower productivity' and increased use of resources."
Mid-level providers, such as PA's and NP's generally spend more time with patients which more likely results in greater patient satisfaction. There is no doubt that many are qualified to do most primary-care tasks.
However, medicine today is all about reimbursement and productivity. Practices are going to find out that when replacing physicians with mid-level providers, the lower cost of employing mid-levels will be offset by a decline in revenue. This study shows that the end result is little, if any, cost savings.
"Because nurses spent more time with each patient, however, they saw fewer patients per hour. In four of five studies on nurse-led urgent care, lower salary costs were offset by this so-called 'lower productivity' and increased use of resources."
Mid-level providers, such as PA's and NP's generally spend more time with patients which more likely results in greater patient satisfaction. There is no doubt that many are qualified to do most primary-care tasks.
However, medicine today is all about reimbursement and productivity. Practices are going to find out that when replacing physicians with mid-level providers, the lower cost of employing mid-levels will be offset by a decline in revenue. This study shows that the end result is little, if any, cost savings.
Posted by Kevin |
link
| Comments (5)
| 
Comments:
Why will not managed care's answer to this issue be the same that was used to decrease payment to doctors or increase productivity, simply require that the NPs or PAs to see more patients per day.Doctors used to spend more time with patients also.
All using NPs and PAs will do is give third party payors a green light to reduce per visit reimbursement even further. They stand only to profit more by doing so; that is the economy of the sweatshop. This merely facilitates the race to the bottom.
# posted by 
: 10:21 AM
: 10:21 AM
There are times when I've seen nurse practitioners struggle to diagnose and care for patients appropriately. I've seen one of them treat a patient's Parkinson's disease with Valium, and nothing else; I've seen another one miss a case of hypercalcemia (there were 4 elevated calcium levels in the EMR, and not one was noted or acted upon!) There are quality issues, as well as productivity issues...(no name, please)
# posted by : 10:38 AM
: 10:38 AM
i blogged these comments: Kevin, M.D. thinks NPs & PAs are not cost efficient because they are less productive, but my experience in urgent care they are more productive than the MDs taking care of sicker patients. and if you're concerned about their usefulness in primary care, isn't patient satisfaction more important than the bottom line? In an area with more indemnity care, more volume means more profits, more patient satisfaction naturally leads to more volume.
Studies show that patient outcomes are comparable for both NPs and MDs. HMOs/PPOs are beginning to list NPs as primary care providers. It is only a matter of time before patients will be forced to visit a NP rather than a doctor. Probably not the best time to go into medicine.
Post a Comment
