Physicians being replaced by midlevel providers is getting some press

[Ferrismonk]

Doctors Are Disappearing From Emergency Rooms as Hospitals Look to Cut Costs - KFF Health News

As a money-saving strategy, emergency rooms are turning to nurse practitioners, physician assistants, and other staffers who earn far less than physicians.

khn.org

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[voxveritatisetlucis]

When New York Times

 

[Ducttape]

imo, most important part of article that has been vexxing a lot of us in terms of finding:

A working paper, published in October by the National Bureau of Economic Research, analyzed roughly 1.1 million visits to 44 ERs throughout the Veterans Health Administration, where nurse practitioners can treat patients without oversight from doctors.

Researchers found that treatment by a nurse practitioner resulted on average in a 7% increase in cost of care and an 11% increase in length of stay, extending patients’ time in the ER by minutes for minor visits and hours for longer ones. These gaps widened among patients with more severe diagnoses, the study said, but could be somewhat mitigated by nurse practitioners with more experience.

The study also found that ER patients treated by a nurse practitioner were 20% more likely to be readmitted to the hospital for a preventable reason within 30 days, although the overall risk of readmission remained very small.

The Productivity of Professions: Evidence from the Emergency Department

Founded in 1920, the NBER is a private, non-profit, non-partisan organization dedicated to conducting economic research and to disseminating research findings among academics, public policy makers, and business professionals.

www.nber.org

But definitive evidence remains elusive that replacing ER doctors with nonphysicians has a negative impact on patients, said Dr. Cameron Gettel, an assistant professor of emergency medicine at Yale. Private equity investment and the use of midlevel practitioners rose in lockstep in the ER, Gettel said, and in the absence of game-changing research, the pattern will likely continue.

“Worse patient outcomes haven’t really been shown across the board,” he said. “And I think until that is shown, then they will continue to play an increasing role.”

its all about money. this is what is great about making healthcare privatized. soon MAs and techs and the drunk down the street will be doing the ER care because it is cheapest.

 

[Pain Applicant1]

There were a lot of important points in that article but as a business owner I know that they're going to focus on the p&l and balance sheet and see that following:

...their top expense: physician labor....“midlevel practitioners,” who can perform many of the same duties and generate much of the same revenue for less than half of the pay.

Fwiw, I used to work for kkr in Manhattan. Henry kravis was the OG corporate raider leverage buyout king. That's who the book barbarians at the gate was written about.

 

[callmeanesthesia]

“Researchers found that treatment by a nurse practitioner resulted on average in a 7% increase in cost of care and an 11% increase in length of stay, extending patients’ time in the ER by minutes for minor visits and hours for longer ones.”

Kaiser is one of the few where that might gain traction. Pencil-pushers in the privately owned ER will look at that and say: cost of labor goes down by over 50%, and the amount of billable services goes up by 7% - that’s a win-win.

 

[Ferrismonk]

Pencil-pushers in the privately owned ER will look at that and say: cost of labor goes down by over 50%, and the amount of billable services goes up by 7% - that’s a win-win.

This comment sums up most of what is wrong with American healthcare.