Let the market set mid-level provider compensation

Let the market set mid-level provider compensation

0 have signed. Let’s get to 500!
At 500 signatures, this petition is more likely to be featured in recommendations!

We, the undersigned physicians and members of the public, object to the Presidential executive order issued on October 3, 2019, as an alternative to "Medicare for All" proposals, and specifically to section 5, which suggests that physicians and mid-level providers, such as nurse practitioners and physician's assistants, are interchangeable and should be compensated in proportion to time spent with patients.

This proposal does not consider the amount of time which physicians spend in training. Physicians complete a minimum of 16,000 hours of clinical training, with frequent and rigorous evaluation and testing, whereas nurse practitioners can be certified after as little as 500 hours of informal clinical observation, with minimal testing. The knowledge, experience and skills which physicians gain through their more extensive training enable them to direct the efficient allocation of health care resources and produce optimal outcomes while minimizing risk, expense and discomfort to patients. If it becomes impermissible to compensate physicians equitably for their expertise and their investment in obtaining it, the shortage of physicians and physician led care will only increase.

Mid-level providers argue that the length of their training relative to physicians is unimportant, because their training is "competency based, rather than time-based." The opposite is true. Physicians spend years developing competence, because that's how long it takes, and then years more demonstrating competence, before being granted the privilege of unsupervised practice. Mid-level providers assert that their competence should be assumed after a fixed, very short, period of training, during which they are not required to individually demonstrate competence for unsupervised practice, because most would not be able to.

When the government attempts to fix the price of goods and services of different values, rather than allowing the market to set prices, the result is distortion of the market, which then fails to produce goods and services efficiently. Our current health care system, which does not provide health care to every American, despite exponentially increasing costs, is influenced by existing distortive policies. It needs more transparency, accountability and competition, not more distortion.

We urge you to revise your proposal to stipulate that the market, and not the government, should set the relative value of health care services on a competitive basis. We also urge you to pursue policies that would increase transparency, accountability and competition, such as truth in advertising legislation, which would prohibit mid-level providers from referring to themselves as physicians or doctors, and require that patients sign informed consent, acknowledging that the difference in training between physicians and mid-level providers has been fully disclosed, and that they understand they have the right to receive care from a fully trained physician.

 

0 have signed. Let’s get to 500!
At 500 signatures, this petition is more likely to be featured in recommendations!