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Consumer Confidential: California faces a doctor shortage. But doctors just derailed a plan to fix it

David Lazarus, Los Angeles Times on

Published in Business News

That's just hooey.

"The only tiers are care and no care," said Karen Bradley, president of the California Assn. for Nurse Practitioners. "We're not trying to replace doctors. We're part of the same team."

As I've previously noted, a nurse practitioner falls between a doctor and a registered nurse. She or he must have at least a master's degree and must receive advanced training in a specialty, such as family medicine.

Unlike an ordinary nurse, a nurse practitioner can order tests, diagnose medical problems and manage a patient's overall care. A nurse practitioner mostly focuses on wellness. More complicated issues are referred to a doctor.

At the moment, California requires that nurse practitioners be supervised by a physician, particularly if they want to prescribe drugs for patients.

The supervising physician is seldom in the exam room. He or she could in fact be miles away and may be in touch with the nurse practitioner only on an occasional basis.

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We're one of about two dozen states that still require such supervision, and the only one in the West to do so. AB 890 aims to fix this.

Among other things, it would eliminate the need for a doctor's oversight after a supervised training period and would allow a nurse practitioner to, for example, prescribe insulin for someone with diabetes or cholesterol medication for someone at risk of heart disease.

This is a big deal because California will be short about 4,100 primary-care doctors by 2030, according to a recent report from the California Future Health Workforce Commission, a blue-ribbon panel co-chaired by University of California President Janet Napolitano and Lloyd Dean, chief executive of Dignity Health.

The commission's recommendations included boosting the number of nurse practitioners statewide "and providing them with greater practice authority, with particular emphasis in rural and urban underserved communities."

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