Enriching Dentists, Doctors by Curbing Nurses, Assistants
|June 3, 2014||Posted by Staff under Corruption, Economic Principles, Health|
This 2014 excerpt of Vox, May 5, is by Matthew Yglesias.
Dentists’ participation in Medicaid means dentists see more publicly insured patients without decreasing the number of visits provided to privately insured patients. Dentists manage to pull this off without increasing the number of hours per week that they work. Dentists don’t do much work in a typical dental visit; dental hygienists are the people who do the vast majority of the work in a dental office — and as a result, more patients increase not dentists’ work time but their incomes.
Waiting times for patients waiting to get in to see a dentist go up modestly. The increased wait times are concentrated in states with relatively restrictive “scope of practice” laws. In some states, hygienists can clean teeth with considerable autonomy from dentists whereas in other states a hygienist can only clean teeth if she’s employed by a dentist.
An essentially parallel situation exists in mainstream medical care. Some states allow certified nurse-practitioners to evaluate patients, diagnose, order and interpret diagnostic tests, initiate and manage treatments. People with serious medical conditions still need to see doctors. But patients with routine care needs can get them taken care of by nurses. Other states, by contrast, create more of a financial windfall for MDs.
Proponents of restrictive licensing say that the issue is patient safety and not greed. But research says otherwise. As Health Affairs has noted, “studies comparing the quality of care provided by physicians and nurse practitioners have found that clinical outcomes are similar” while subjective measures of patient satisfaction indicate that nurse practitioners do better than MDs.
As the number of people with insurance rises thanks to Obamacare, that’s great news for doctors but a much worse result for patients than we could achieve if we changed these laws.
Ed. Notes: Competition among competent providers is one main way that markets are efficient and why they need to be free of statist interference. Let government handle cases of fraud. The law need not create oligopolies and monopolies but instead defend our rights.