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Facing doctor shortage, lawmakers want to redefine healthcare roles

February 11, 2013|By Michael J. Mishak
  • Nearly 30% of California's doctors are nearing retirement age, the highest percentage in the nation, according to the Assn. of American Medical Colleges.
Nearly 30% of California's doctors are nearing retirement age, the… (Katie Falkenberg / For The…)

SACRAMENTO -- Facing a doctor shortage in California, state lawmakers want to fill the gap by redefining who can provide healthcare in the Golden State.

As detailed in Sunday's Los Angeles Times, they are working on proposals that would allow physician assistants to treat more patients and nurse practitioners to set up independent practices. Pharmacists and optometrists could act as primary care providers, diagnosing and managing some chronic illnesses, such as diabetes and high-blood pressure.

The effort is being led by state Sen. Ed Hernandez (D-West Covina), an optometrist and chairman of the Senate Health Committee.

Currently, just 16 of California's 58 counties have the federal government's recommended supply of primary care physicians, with the Inland Empire and the San Joaquin Valley facing the worst shortages. In addition, nearly 30% of the state's doctors are nearing retirement age, the highest percentage in the nation, according to the Assn. of American Medical Colleges.

The effort faces stiff opposition from doctors, who say non-physicians should not exceed their training and that giving more authority and autonomy to nurse practitioners and others could jeopardize patient safety. It could also drive up costs, because those workers, who have less medical education and training, tend to order more tests and prescribe more antibiotics, they said.

While the Brown administration has not taken a position on the issue, Diana Dooley, secretary of the state Health and Human Services Agency, said in an interview that expanding some professionals' roles was among the options policymakers should explore to help meet the expected demand.

"We have got to change the overall delivery system. We can't succeed doing business as usual," she said. "I don’t think there’s any stone that can be left unturned. We have to look at every possible way to make the delivery of care better for patients and less expensive."

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michael.mishak@latimes.com

twitter.com/mjmishak

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