A growing trend in health care is team-based care, in which several professionals with a wide range of skills and expertise work together to address patients’ varied health care needs.
Although the concept is evolving and will require changes by everyone from medical and nursing schools to insurance providers, many health care practices and hospitals have embraced the concept of team-based care.
At the center of a dynamic health care team is the patient, whose needs direct which professional can best lead the entire team at any given time. The American Association of Nurse Practitioners defines team-based care as consisting of at least two providers, but the list of possible team members is seemingly limitless: primary care doctors, nurses, nurse practitioners, specialty physicians, physician assistants, community health workers, rehabilitation specialists, social workers, pharmacists, and patient navigators.
It all depends on the health, mental, and social needs of the patient. As those needs change, the team members change to address them, resulting in more comprehensive health care.
Multiple studies have found that team-based care is associated with improved patient outcomes, especially in hospitals. Plus, spreading the care over a network of professionals can improve access to care.
The country already suffers from a shortage of primary care physicians (PCPs) that is predicted to grow worse. Nearly 35 percent of Pennsylvanians live in an area or population that has inadequate primary care access. In 2017, only one in six medical school graduates chose primary care residency. One calculation shows a PCP with a typical 2,000-patient load intent on providing comprehensive care would need to work 21.7 hours a day, seven days a week.
That’s why the provision of care by other health professionals such as certified nurse practitioners (CNPs) can have a positive impact.
But nurse practitioners are hamstrung in Pennsylvania by laws that require them to practice under a collaboration agreement with a physician at all times.
Twenty-two states and the District of Columbia allow CNPs to practice to their full authority. Under legislation (Senate Bill 25) moving through the Pennsylvania General Assembly, CNPs would be able to practice to the full scope of their licenses without physician supervision after they have worked under such supervision for three years and 3,600 hours.
CNPs simply do not need unending physician supervision when caring for patients within the boundaries of their training. This commonsense bill can improve access to care while continuing to ensure the quality and safety of patient care.
Studies have shown that patients treated by APRNs have similar health outcomes to patients who are treated by physicians.
Last session, the same legislation won Senate approval but was not considered by the House.