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On the Brink of Change: NP, PA Leaders' Hopes for 2009

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And on the other end, where’s your workforce? Who’s going to see all these people? You’re between a rock and a hard place. [At the American Medical Association meeting last month] Massachusetts was at the microphone a lot talking about their universal coverage plan, the theory of it and what has developed. Everybody hasn’t even tried to get care yet, but [with] just the increase from everyone knowing that they have access, people are still waiting in line. There just aren’t enough providers. So, my theory is, there are enough sick people to go around. We all have to work together on that and see what the strengths of each group are.

In an ideal world, what would you like to see achieved in terms of health care reform—in general and with regard to NPs/PAs—by the end of 2009?
Swanson:
I would like to see that health care is valued and is a right and not a privilege. In an ideal world, everyone would be able to receive health care services. The system would not be physician-centric or system-centric; it would be patient-centric.

We would have electronic health records so that we could communicate among systems. There would be a central repository for an individual’s health records that they themselves could have access to, so that you would never show up in a venue and not have a history for a patient.

There would be no barriers. All qualified providers would be able to provide the services that are needed, without turf issues and false claims of quality—we all know the quality issue is a trumped-up issue. There’s plenty of data out there that people other than physicians probably are better qualified to provide primary care services. So I would like to see no barriers to information, to access, to quality.

Lord: I would certainly like to see a cultural shift—which, in medicine, will certainly be a shift—where we acknowledge that we all are part of this team and that patients come first. There are so many different groups and types of providers, at all different levels; if we could all acknowledge that everyone plays a role, I think we’d get the most out of it. We truly would improve patient care. So there’s my “save the world and create world peace” answer: that we all truly function to the max and don’t worry about who’s stepping on whose toes.

And from a PA’s standpoint, I hope that we see full engagement of the Academy and the PA community in health care reform. I certainly would like to see, instead of us knocking at the door, saying “Please make sure we’re included,” that groups come to us, to the Academy, and say, “We want you at the table. What is your plan? What do you have to offer?”

It can’t just be done legislatively; it can’t just be done by the payers. Everyone has to work together to develop that plan. It’s an exciting time, because everyone wants change. The country wants it; it’s not just one political group. Patients want it, and they’re speaking out. We’re advocating for our patients. I think those things continue to be really important.

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