I visited with Senator Jeff Bingaman’s health staff this week. (I am a voter in New Mexico, where we have a growing coalition of primary care advocates.)
They told me, and it has been confirmed by others, that the ACOP is organizing an opposition among the primary care groups to bills that allow non-physicians to be primary care providers. In a state like New Mexico, where there is a dire shortage of primary care providers, any primary care reform has to involve nurse practitioners, which makes this opposition so disappointing to Senator Bingaman, who is poised to become the leading figure in the Senate Health Committee. If we want a medical home bill, we must be prepared to advocate strongly for it. Otherwise, it will lose.
It would be indeed unfortunate if the medical home coalition, building so successfully over the past couple of years, died on the vine because of opposition to non-physician providers.
As long as we think clearly about what the medical home is geared to (first contact, person focused care over time, comprehensive, and coordinated), and gear our qualifications as medical home provider to achievement of these goals, we have nothing to fear from non-MD primary care providers.
The point is to keep our eye on what it is we want to achieve, and not get distracted by secondary considerations which, in the end, we can manage by being firm about what primary care really is.
I hope that the American College of Physicians actions will not do anything to jeopardize the medical home movement. If we are supportive of Congressional bills that are aimed at building primary care in the US, I think something very important will come out of Congress this year.
Barbara Starfield MD MPH (shared with her permission)