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Nurse Practioners Say They Could Ease Rural Health Care Shortage With More Authority, But Doctors Say It Won't Work

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Population studies show that rural communities tend to have high numbers of older residents who rely on Medicare and Medicaid, which reimburse health systems at lower rates. This can make it hard for health care providers to make money in more remote areas, resulting in service cuts and closures. In an April report, the Center for Healthcare Quality and Payment Reform, a policy group, estimated that seven of Pennsylvania’s 41 rural hospitals, for instance, are at immediate risk of closing.

Melany Chrash, a nurse practitioner in Fayette County, said that preventative care and patient education are core to her work. She said full practice authority would give providers like her the flexibility to plan appointments around patient needs and reach underserved areas. And if there’s an issue she can’t handle, Chrash said she has no problem referring patients to a specialist.

“It wouldn’t change how we practice,” she told Spotlight PA. “It would change the fact that we can be independent and run our own practice the way we see fit, and we’re not sharing our salaries with someone else.”

 

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Of course the doctors' groups are going to resist. 

For the most part, an NP could be more beneficial to the patient than a physician who is on a pay scale based on how many patients they see on an hourly basis. When I was really sick a few years ago, I got in faster seeing the NP at my doctor's office and it was a good thing too. She was very thorough, didn't rush me through, and it wss a very positive experience. In fact, I considered following her to the practice she went to, but decided the drive could be inconvinient. 

 

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Agreed ! I see four NPs In Specialty practices, all by my choice . They have taken up the Medical Practice of old where the patient is made to feel  they are listened to and count for something other than a freaking statistic or body count . As Chris says a ,pay scale , we used to call that “piece work” ! 

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