Care value is not based on license

By | October 10, 2017

Recently, I have been reading publications regarding the “debate” over what type of patients should be seen by which licensed professional. Frequently this discussion revolves around the usage of Nurse Practitioners, or Physician Assistants versus Physicians. Well discussed arguments for both are abundant.

Neither side of the conversation, however, truly has anything to do with the license one has obtained. As a licensed and board-certified MD, I have encountered matters better suited to others. My license is more about a regulatory issue and has less to do with the skill or experience. For example, as a Hypertension Specialist, when my patients need dietary counseling and stress management, I am neither the most appropriate nor the best-qualified person even though I have a license that vouches for those skills.

Therefore, in treating a patient, let’s focus on who has the ideal skills and experience. This requires shifting the conversion to that of quality and outcomes rather than licensing. As professionals, it is incumbent upon us to ensure that those we serve are receiving what is needed by those adeptly qualified to deliver the care. Success is dependent on monitoring skills and results rather than licensure renewal. Ongoing education must shift to continuous improvement rather than just credit for learning something new. Licensure obtainment and continuation will require this ongoing scrutiny if we are to focus on outcomes.

As healthcare delivery evolves to a team-based model, let’s ensure that each team member is best suited for the role they play. For instance, athletic teams have mastered this concept to a more preponderant degree than medical teams. Obviously, for them, the outcome is simple to measure, final scores indicating the superior team. While healthcare is not as straightforward, the goal of using each of our skills and experiences to their greatest degree holds true.

While I am not advocating for allowing anyone to do anything, I am pushing all to consider the question differently and thus revise the present mental model. If my patients are better served by others, regardless of license, in a matter that truly enhances the value that is delivered, and then my goal is met. Let us not focus on the license, but rather the true value that needs to be delivered.