Hospitals are happily benefitting from the expanding role of paraprofessionals and from the top level professional degrees, the doctorate, those paraprofessionals are now obtaining.
Take, for instance, the push by CRNAs to be recognized as equivalent replacement providers of anesthesia services. Hospitals, seeking to break the financial and medical staff voting block hold of anesthesia groups, are often more than willing to accept CRNAs in place of anesthesiologists. They view them as cheaper, more controllable and disposable.
If you’re not an anesthesiologist, don’t think this doesn’t apply to you — in a very real sense, anesthesiologists are simply the “canaries in the coal mine.” Soon, surgical PAs will be pressing for the ability perform some procedures unsupervised.
At the same time, doctorate degrees are becoming the top professional degree in many paraprofessional categories. Once the nurse specialist performing your function becomes a “doctor,” you will become irrelevant – or so goes the thinking of hospital-centric healthcare pundits.
Physicians do have one important branding tool, the “M.D.” degree. Of course, as paraprofessionals become branded as doctors also, the value of an M.D. will become diluted. Physicians cannot allow that to happen and your professional societies must begin now in educating the public on the difference between M.D. delivered medicine and care delivered by nurses and other physician extenders holding doctorates.
Additionally, physician specialty boards, which to the public are generally meaningless (after all, what do all those initials after a physician’s name mean?) must devote significant resources to promote the public’s awareness of the high-level of training and peer-reviewed expertise required in order to earn that designation and, even more importantly, what that means to patients and their families.
It’s bizarrely amusing, in a sick sense of the use of that word, to see hospitals demanding that all physicians in a contracted group operating a hospital-based department be board-certified, while, at the same time happily replacing a significant portion of those doctors with far lesser trained nurses. If medical specialty boards don’t understand this is an absolute repudiation of the value of board certification, and an attempt to render their members’ roles, and perhaps most if not all physicians’ roles meaningless, and therefore, fail to act, they, and you, will be in for a significant surprise.
Mark F. Weiss