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  • Scope of Practice feedback to CMS

    Sorry if I missed any posts on this, but I was curious what clinicians thought about all this discussion about “practicing to top of license” and scope of practice stuff. I’d imagine this has a lot of financial implications for doctors (negative) and administrators (positive).

    looks like today is the last day CMS is taking feedback on this topic. I’m not one to believe these emails make a difference, but I’ve spent 5 minutes in worse ways before.

    https://www.cms.gov/files/document/f...tm_name=iossmf



  • #2
    Seems geared toward midlevels. How could others be expected to weigh in on whether the expanded privileges are appropriate if they aren't aware of what is being requested? Unless someone wants to enlighten CMS that there are virtually no admission requirements (paying tuition doesn't count) or standardizations in these programs so deciding which individual has the necessary background and skill set would be nearly impossible.

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    • #3
      Originally posted by CMS
      We also continue to welcome your input on ways in which we can reduce unnecessary burden, increase efficiencies and improve the beneficiary experience, and request that input on such topics only be sent to this email address with the phrase “Scope of Practice” in the subject line if they relate to the specific areas in regulation which restrict non-physician providers from practicing to the full extent of their education and training.
      Cease to exist would probably be a good start.

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      • #4
        That was a fun 5 min of giving the government a piece of my mind.

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        • #5
          A response from several organizations...

          ACEP signed onto this before the final version.
          Attached Files
          Last edited by southerndoc; 01-18-2020, 08:22 PM.

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          • #6
            Email sent. Now I'll just wait for the knock on the door.
            $1 saved = >$1 earned. ✓

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            • #7
              "Physicians complete 10,000-16,000 hours of clinical education and training during their four years of medical school and three-to-seven years of residency training. By comparison nurse practitioners, the largest category of APRNs, must complete only 500-720 hours of clinical training after two-three years of graduate-level education. Physician assistant programs are two-years in length and require 2,000 hours of clinical care."

              Quote from letter attached above. I educated myself on this recently. Everyone should remember that the quickest route to a profession is the route most will end up taking. To be a practicing MD/DO you have to have go to 4 years of medical school and a minimal 3 year residency and pass at least the USMLE's 3 steps. To be an NP you have to get your undergraduate degree in nursing, 18 month master program, and shadow a doctor or another NP for 3 months (500 hrs at 40 hrs/wk = 12.5 wks) and pass one test. To be a PA you need the "clinical care" time to be paid and prior to you doing a 18 month master program and pass one test. This prior paid work can consist of being an ER tech for a year (requires no specific training). Those taking 3 years to become a NP/PA are usually working part time as a nurse or tech to make ends meet or reduce student loan burden and usually have summers off.

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              • #8
                As a physician anesthesiologist, I have the opportunity to work with CRNA's, and I've always felt they serve as an extension of my mind and my hands to help get the work done day to day. They are not here to be a replacement. Do others feel this way about other NPs/PAs in other specialties?

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                • #9
                  Originally posted by FunkDoc83 View Post
                  As a physician anesthesiologist, I have the opportunity to work with CRNA's, and I've always felt they serve as an extension of my mind and my hands to help get the work done day to day. They are not here to be a replacement. Do others feel this way about other NPs/PAs in other specialties?
                  no. PAs at my clinic are seeing patients on their own. notes being signed off end of day.
                  even promising to send abx in a few days if youre still not better.....

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