(10-28-2014 02:00 PM)BobL Wrote:  My last comments on this issue(I hope):

Mine too, I hope

Quote:As to the studies its not just patient satisfaction that is measured(and I agree with you on this) but also medical outcomes(honestly I dont know enough about how that is determined).

Here is the difference. I specifically do. I'm in hospital adminstration (not a practitioner, but trying to make sure my hospitals meet all of these new measures... so I do silly things like put chairs in hospital rooms and encourage my doctors to sit when they talk to patients to give the impression that they spent more time with them than they did) Medical outcomes isn't exactly what you think it is (it is something essentially dealing with national averages and diagnosis codes) and to the extent that it is, I've already agreed that for most patients and most ailment, a PA or NP is sufficiently qualified to take care of them.

However, that isn't what we were told Obamacare would do. The next time someone shows me a quote from someone within Obama or Pelosi's office PRIOR to the bill being passed and becoming the law of the land where they essentially say that in order to control costs, we need to let less stringently qualified people provide more of the care and let MDs focus on the more severe cases will be the first. For me, I would have accepted that position because of what I know. Owlnumbers and you and others probably as well... but that isn't what 'the masses' thought.

Quote:As to PA's and NP's I'll use different analogy:
Years ago dentists did your teeth cleaning, exams and administered local anesthetic shots..now this work is done by dental hygienists. Personally I never noticed a difference in quality of care. I am certain some did not like the idea especially regarding the local anesthetic but I dont recall there was any kind of uproar over this.

Once again, what you're willing to accept and what you're told will happen are not the same thing... and PAs are not a creation of the ACA.

We were told you can keep your doctor... period... now we're being told you can keep your doctor, as long as your doctor was actually a PA and not an MD.

As to your experience, I'll accept that this was your experience... but I'm now 50 with kids in their 20's... so I've seen a lot of changes over the years... but never has anyone but the Dentist (who isn't as qualified as an Orthodontist or an MD) given anyone in my family a shot... but even so, there is a big difference between farming out teeth cleaning or Xrays and farming out diagnosing diseases or drilling. In the hospital, an X-Ray tech takes your X-rays and a nurse cleans your wounds. That's about as close as I can come to your example. It's still the most qualified person in the office and not a dental assistant who makes a determination about what your x-rays 'mean' to determine your course of care.

The better analogy would be if we were talking about having your dental hygienist diagnose your irritated gums and prescribe pills to cure it. I'm sure there are many of them with enough experience to do that with high accuracy, but that doesn't make them as qualified as a dentist, much less and MD.

I think it's fine that we employ more PAs. I think it's fine that we push more care to PAs to save money... but we were already doing this and didn't need the ACA to make it happen. In no way is this a 'benefit' of the ACA.

I don't think most of the people who voted for the ACA knew or thought that this was how we would address the shortage of physicians... by letting people who AREN'T physicians deliver more medicine.



The problem with these sorts of arguments is that we try and narrow them down to just a few words... and then people 'pick apart' the fact that those few words are perhaps not as clear as a ten page description... but at the end of the day, the general basis of my claim was that the ACA doesn't create more or better healthcare... and despite the protests, nobody has really claimed, much less shown that it does.