Provider Status Essay

Despite all of the on top of, it's going to appear that giving patients medication isn't a very troublesome task, but it's one with life and death implications. According the U.S. Food and Drug Administration medication

In the United States, health care accessibility, quality, and affordability continue to be ongoing topics of discussion that effect many Americans on a regular basis. The need for affordable, quality healthcare continues to grow, not only due to a growing elderly population, but also as a result of the Affordable Care Act which has allowed millions of previously uninsured Americans access to health insurance and therefor better access to healthcare services (Patient Protection and Affordable Care Act, 2010). According to the Institute of Medicine (IOM) the projected demand increased for healthcare have led to a call for expansion of primary care services by policy makers (Institute of Medicine, 2010; National Governors Association, 2012). Since Advanced Practice Nurses or Nurse Practitioners (APNs or NPs will be used interchangeably for the purpose of this paper) are one of the fastest growing groups of healthcare providers, and continue to practice and provide care in a range of settings including primary care, it is important to investigate and address any potential barriers to practice. This author believes that allowing APNs to write prescriptions for commonly used controlled substances will help improve timeliness and flexibility in health care delivery; studies have shown that there is a positive impact on high

been restricted on what they can and can’t do including signing certain documents and orders they can prescribe. With the Affordable Care Act the demand for primary care providers is growing (Gadbois, Miller, Tyler, & Intrator, 2015). This means that the need for APRNs is rising and the need change is approaching. In the primary care setting, there is a variety of medical staff working including medical assistance, LPNs, and RNs. This can become more for the APRN when delegating medication administration. When the APRN cannot delegate medication administration the quality of patient care is sacrificed and is not productive in providing care to the patients.

Whether you love it, hate it, support it, or detest it The Affordable Care Act as it stands, has been making waves across both news headlines and the medical community alike. For the most part, the focus of the act has been placed on the impact it will have on the consumer or the patient. However, the pharmaceutical division of the medical community is among the groups that are most impacted by the Affordable Care Act. In particular, retail pharmacies are feeling the effects of the act via the reimbursements and provisions surrounding the reimbursement policies that have been altered with the passing of the Affordable Care Act. Reimbursements and the provisions implemented upon retail pharmacies by the Affordable Care Act could prove to be detrimental towards the success and profits gained by private retail pharmacies.

When doctors prescribe medication for their patients, a local retail pharmacy is most likely to be utilized to fill the order. However, there is a growing population of older Americans that are no longer able to live independently and must reside in nursing homes or assisted living facilities. In order for this vulnerable population to receive their medications, a different kind of pharmacy is needed, these are known as LTC, long term care pharmacies. Within these specialized pharmacies there are highly trained employees called CPhTs, certified pharmacy technicians who are overseen by state licensed

One class of American citizens view on the Patient Protection and Affordable Care Act is doctors, and it is very negative. Third-party payment plans already hinder the independence and integrity of the medical field. This act now will reinforce the worst of these features. Physicians will fall prey to more government regulation and oversight, and will now be increasingly dependent on a not to reliable government reimbursement for their services. A doctors job will only be become more difficult.

In the State of California, the Business and Professions Code pertaining to Healing Arts, makes provisions for Nurse Practitioners (NPs) and Certified Nurse-Midwives (CNMs) to gain prescriptive authority (CA BRN, 2002, CA BRN, 2010). This policy stipulates this privilege to be accompanied with the stringent criteria that NPs and CNMs can only furnish prescriptions and medical devices under the supervision of a physician or under standard protocols sanctioned by physicians. The California Board of Registered Nursing (CA BRN) along with the State’s Business and Professions Code do not however, advocate for the inclusion of Clinical Nurse Specialists (CNSs) amongst those APNs authorized to be able to furnish (California’s legal terminology for “ordering” medications) prescriptions (CA BRN, 2003).

With the huge shift in the U.S. healthcare system, healthcare services are now trending towards value-based outcomes.1 With passage of the Affordable Care Act (ACA), it has become increasingly important to improve quality of care while simultaneously reducing health care costs.2 Pharmaceutical care services are one of the key components that has an essential impact on optimizing therapy outcomes; minimizing cost and enhancing quality of life of chronically ill patients. Community pharmacists are the third largest healthcare provider group in the world after physicians and nurses.3 Despite the fact that many studies have shown that community pharmacists’ provision of direct patient care can lead to improved patient outcomes and reduced health care costs. However, community pharmacists are the only health professionals who are not primarily rewarded for delivering health care and hence are under-utilized as public health professionals.3 Community pharmacists could help to improve health by reducing drug-related adverse events and promoting better medication adherence, which in turn may help in reducing unnecessary provider visits, hospitalizations, and readmissions while strengthening primary care delivery across the health system.

As resistant as some states’ legislative and regulatory bodies are to grant APNs autonomy of practice, the damage being done by over-regulation is clear (Safriet, 1992). Physicians are forced into a position to either supervise the APN’s practice or be constantly consulted for approval of their practice decisions. Safriet (1992) described that in and of itself, this constant supervision may appear to patients that the APN is not competent to provide adequate or care equivalent to that of a physician. If the role of the APN is to bridge gaps in health care by relieving the medical establishment of some of the patient load by performing the same function as a physician in a primary care setting, it seems wholly unnecessary to restrain their scope of practice in those areas. This type of restrictions affect cost and patient care accessibility (Safriet, 1992). This was a problem stated in the article, however 25 years later, populations of patients remain unseen or cared for and APNs continue to be underutilized (Safriet, 1992). Rigolosi and Salmond (2014) cite the American Association of Nurse Practitioners (AANP) when they state that not utilizing nurse practitioners due to practice restrictions costs $9 billion annually in the US (p. 649).

Provision of care to the patients involves a collaborative work of different professionals. These include paramedics, laboratory technicians and those specialized in imaging. For the provision of quality care to the patients these professionals must play their duties accordingly (Dent, 2012). In the case of Hooks SuperX, Inc. v. McLaughlin the pharmacists are being accused of filling drugs at a faster rate causing harm to the patient, McLaughlin.

In order to meet the growing demand for primary care, nurse practitioners need prescriptive authority to provide quality, safe, and cost-effective healthcare to patients. The development of nurse practitioners, plus physician shortages in primary care, leads to an increasing need for nurse practitioners and access to health care. However, nurse practitioners currently face prescription regulations for controlled substances, which limits their scope of practice. The regulation of nurse practitioners prescribing controlled substances diminishes comprehensive health care services by increasing the wait time for patients and liability claims for physicians. The number of nurse

* Medicare/Medicaid, to be sure the doctor is not banned from caring for Medicare/Medicaid patients

nurses. Rural Health Clinic Status is listed as a #14 provider type should the additional providers

As well as using multiple physicians, elderly clients may use more than one pharmacy. Each pharmacy attempting oversight of the client’s medication use may not be aware of all the medications prescribed.

Today in the 21st century the roles of pharmacist have expanded tremendously. Before pharmacist had the role of solely dispensing drugs. Pharmacists were limited to only being regulatory or clinical pharmacist. Back then they were called medical purveyors who were much like today’s regulatory pharmacist and hospital pharmacist who are similar to hospital pharmacist. Now pharmacists carry many roles in healthcare. Pharmacist can play roles in public health, community, health systems, state, and federal government.