A federal agency is weighing whether to reimburse a specialized type of nurse for giving chronic-pain treatments, a move opposed by some doctors and one that critics say could complicate the battle against prescription painkiller abuse.
The physician is the highest-trained team member. It therefore falls to the physician – as both provider of care and manager of services delivered by others on the team – to supervise, implement science-driven and objective treatment protocols, coordinate the services of other professionals as well as medical specialists, and ultimately remain accountable for each patient’s care.
Integrating the talents of a diverse medical team under physician leadership will be one of the key challenges in the coming decade. Without physician direction, supervision, and management (or if the system evolves to accommodate teams led by practitioners with lesser training), medical care will trend toward even more fractured care, higher-than-necessary utilization, and creeping inefficiencies. This will lead to even higher costs, duplications of services, and lower-quality patient care. These inefficiencies in turn will hamper efforts to improve access to care.