The Under-appreciated Professions

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The four occupations included in thisblog are among the most under appreciated professions. They stillcan have people within the profession that are bad apples for theprofession. Most are a credit to the profession and do their jobseffectively and efficiently. Physician's assistants, nursepractitioners, nurses, and pharmacists are the occupations for thisdiscussion. All have national organizations for support andadvocacy. With the looming shortage of physicians, theseprofessionals will serve a vital role in medicine and seeing patientson a more active basis. Links to professional organizations will bethe profession below.
Nurses, whether they are registerednurses or any of the 68 different types of nurses, they have a roleto fill and in general do excellent in their profession. The list of 68 may not be inclusive, but shows many of the areas that nurses maybecome specialized for their profession. Under the physicianshortages, they will need to step forward and learn how to handle anever-increasing load. Those that can obtain some additionaleducation quickly will be in line for promotions and work in thisexpanded need.
Nurse practitioners (NP) and physician assistants (PA) will find more physicians that are more willing towork with them and expand their roles under the physician shortage. They will need to be cautious, as there will still be some physiciansthat will not accept their role or even work with them. Thesephysicians will do more to damage the medical reputation ofthemselves and those round them. Physician shortage will not be easyfor those still practicing.
If some of the hurdles can be removed,nurses, nurse practitioners, and physician assistants will in some ofthe more rural areas, be spending more time visiting elderly patientsin their homes and using video conferencing (telemedicine) ortelephone if necessary. Except in the states that have passed lawsrequiring physicians to physically see the patients before they canissue a prescription, physicians in the rest of the states should beable to issue prescriptions with the assistance of nurses, nursepractitioners, and physician assistants. In a small number of statesalready experiencing physician shortage, there is some talk aboutamending the law to allow these medical exceptions when drivingdistance is an impediment to physically seeing a physician.
The position of pharmacist is stillbeing discussed, but physician resistance for allowing any pharmacistto issue prescriptions is still strong. One state is consideringsituations where a pharmacist would be able to renew prescriptionsespecially for certain chronic diseases like diabetes. Anotherlargely rural state is considering allowing pharmacists with certainqualifications to be able to work with physicians in a capacity likenurses. Pharmacists in hospitals, assisted living facilities, andnursing homes may be given more responsibilities and with continuingeducation expand their roles even further.
Some pharmacists are already expandingtheir own roles in some of the larger chain pharmacies and thisshould also be considered and supported. Too many patients do notutilize their pharmacists to prevent polypharmacy conflicts. I thinkthat there needs to be restrictions placed on patients using onepharmacy for one medication and another pharmacy for a differentmedication. If nothing more, pharmacists need a technology system tobe able to access by name and social security number all pharmacieswithin a certain parameter to search for medications being taken by apatient to prevent medications conflicts. It is not unreasonable tofind patients using three or more pharmacies for prescriptions and Ihave a few acquaintances that use this to keep (supposedly) othersfrom knowing what other doctors are prescribing. I suspectprescription abuse to be honest.
Depending on how critical the physicianshortage becomes will determine much of the expanded role for nurses,nurse practitioners, physician assistants, and pharmacists. Thosethat are willing to seek additional education now will be able tocapitalize later. I know of two nurses presently studying to becomenurse practitioners. I have written about the role of pharmacistshere and need to say that some of the questions have been answered,but not all have been explained to anyone’s satisfaction. Walgreens has even gotten even more secretive while other pharmacieshave become more open and transparent in what they want for theirpatients. Some of this is good while some actions do raise morequestions.
It will be interesting to see whathappens during the upcoming physician shortage. How long will weneed to wait to get an appointment, how long will it be betweenappointments, will emergency departments continue to exist in somerural areas, and how many minutes will we have available with thedoctor during appointments? These and many more questions areclogging my brain. I can only hope that I am fortunate enough toavoid many of these problems.