Regarding “Nurses group: AAFP 'out of step' on medical-home leadership
," discussions about nurse-practitioner and medical-doctor practice almost always come down to who has the most education, the most experience or the longest time being trained. The essential question really should be, “What level of education, experience and length of time in training is optimal for providing a given level of care?”
To the best of my knowledge, no one has researched the effect of length of education on patient outcomes, per se. European medical education is not based on the four years of undergraduate and four years of medical education that American physicians receive, yet European primary-care patients seem to be doing quite well.
By extension, then, isn't it possible that something other than the 4+4 model provides the appropriate level of education, without overdoing it? A nuclear physicist knows a great deal more about the production of electrical energy than a licensed electrician does, but when I need the wiring in my house fixed, I don't hire a physicist. The electrician's combination of knowledge and skill is a better match for my needs.
I think our patients would all be better served by moving the debate away from who has the most education and into what education and skill is the best match for primary care and how that education and skill can be gained.
Practice associate professor
University of Pennsylvania School of Nursing
Gerontological nurse practitioner
Living Independently for Elders, Philadelphia
While I will give Modern Healthcare some credit for disclosing the source of the “research” that led to and was offered in support of the article, “Romney plan would mean more uninsured: report
,” I would suggest that a more transparent headline would have read, “ACA architect claims Romney plan would mean more uninsured.”
Not only would that have been more transparent, it would have properly cast this “news” article as a biased piece of outcome-based research, saving me the trouble of having to open a link I thought was going to provide me useful information. Research regarding a product, service or policy that is written and/or funded by a competitor to that product, service or policy is about as newsworthy as a story about a dog biting a man. I would expect no less from someone who helped design and implement the ACA that they would find a possible competitor to that plan inferior.
It's no different than if Chrysler released an article on its “research” showing all other cars are more dangerous than the company's own.
Regarding “Allscripts mum on sale rumors
,” will someone step up and take Allscripts out of its misery?
Hard to imagine who, since Siemens has had such great results with its SMS acquisition (almost 10 years ago now) and not much to show for it. GE did so well with IDX, and as for McKesson ... well, you remember HBOC, right? What Allscripts does have is a large client base, and that is worth something, but not $22 a share.
Its best bet is to find a “sucker” across either pond that is willing to pay a premium to buy into the U.S. healthcare market.
Kelzon Group, Barrington, Ill.