The role of the physician in health care is undergoing a major change, and fighting that change too hard likely is a waste of time.
Physicians are going to lose some of their autonomy and may take a hit in compensation, mainly as a result of the juggernaut known as health care reform.
Being a journalist who has seen my chosen field change drastically, I understand why a doctor would be inclined to try to oppose the forces that are imposing unasked-for change.
But those health care forces are virtually impossible to stop for now, so physicians can fight over every last scrap of the shrinking health care pie or, instead, can help figure out how to bake a better pie.
I'm thinking in particular of the current situation in which some physicians are opposing greater autonomy for advanced practice nurses and other similar providers, while at the same time others are lamenting that physicians are miserable, leaving the field in droves and deserving of empathy.
My view is admittedly affected by the fact that my wife works as a certified nurse midwife, a provider that could benefit from ramped up independence from doctors.
But that doesn't change the fact that if physicians are overworked, it would at the very least be an option for consideration to make greater use of nurse practitioners and their kind to fill in the gaps.
The Medical Group Management Association supports the concept of hiring such caregivers, which they call nonphysician providers. The organization just released a study that found increased use of providers like nurse practitioners and physician assistants was associated with higher practice compensation.
"In primary care practices, they can provide 80 percent or more of services with equal or better patient satisfaction at a lower cost than a physician," says MGMA's David Gans, senior fellow, industry affairs, in the study. "Many times, NPPs have fewer demands than physicians and are more readily available to patients," Gans says.
The report, called "NPP utilization in the future of U.S. healthcare," also includes tips on how to hire, use and pay such providers. Compensation ranges widely. The median nurse practitioner pay in 2012 was $94,000 in 2012, while for a certified registered nurse anesthetist it was well over $150,000. Either choice would cost less than a comparably specialized physician.
Doctors understandably feel besieged, and ceding more duties to nurse practitioners or physician assistants might seem counterintuitive. Their world is changing quickly and the transformation only appears to be taking things from them. In the short term, that is likely the case. In the long run, though, doctors could and should play a central role in a redesigned health care system. The more they participate in that redesign, the better off they will be.