Note to Self--- Who Needs Doctors Anyway??

This is the Title of US News and World Report Jan 2005 issue. This article discusses the mainstreaming of mid level providers as nurse practitioners and physician assistants in delivering care to the masses. Physicians see this as necessary to maintain income levels in practice. Busy pediatrics practices are notorious for utilizing these recources. This is one of the adaptations pediatricians are making to keep practices profitable. The problem with this is that patients hate the disruption of continuity that these midlevel providers create for their families, particularly with an ongoing pediatric illness. There are some pediatric offices in St. Louis which have a policy of alternating nurse visits with physician visits. There are some in which you can only see your MD for well checks and see nurses for sick visits. So what we have in this country is a splitting faction of primary care providers. There will be doctors who utilize nurses to make practices financially fit. There is a second growing faction of practices that will utilize administrative support solutions as MDVIP for internists and Personal Pediatrics for pediatricians. These doctors will see patients without the aid of mid level providers and the patient ( read client ) will happily pay a yearly retainer for the physicians expertise. In the year 2006 mainstream insurers do not pay for doctor visits, they will pay for someone to see you, but physicians have figured out how to delegate that responsibility to others and still retain 100 percent of insurance billings if they sign off on the chart!! We'll discuss more on how this impacts malpractice risk tomorrow!

Personal Pediatrics the Pediatrician of the Past and Future... Today.