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BREAKING NEWS

Eliminating Midlevel Providers: The Gap Remains a Mystery

August 17, 2023, USA – Shattering news in the health care community sent shockwaves across the country yesterday afternoon: Midlevels, defined as Nurse Practitioners (NPs), Clinical Nurse Specialists (CNSs), Certified Midwives (CMs), and Nurse-Midwives (NNMs), will be obsolete by midnight if a comprehensive plan isn’t implemented before then.

Amid concerns about potential job losses, patient access issues, and the subsequent upheaval it may create within the complex healthcare network, we reached out to esteemed healthcare administrators, thought leaders, and industry insiders for their professional opinions.

When asked who could bridge the gap without midlevel providers, stakeholders pointed towards five alternatives in the medical fraternity:

[Header Level 5]
A. Patient-Centric Services: Emphasize Frontline Assistants & Ambulatory Team Members
Many healthcare entities are recognizing the value and potential for augmented patient flow management via designated patient champions, administrative specialists, registered nurses (RNs) with increased workload, care coordinators, and care managers to ease the crunch.

Key Words: Telehealth Expansion, Care Transformation, Remote Medicine

b. Technological Solutions (Telehealth 2.0):
Several healthcare informatics organizations anticipate that streamlined digital pathways could facilitate secure, 24/7 patient connections and data processing, significantly bridging medical gaps left behind by phasing out midlevel physicians.

Must-Watch Articles: 21st Digital Healthcare: Shaping Better Patient-Centered Care #TeleHealthExplosion [1]; Efficient Data-driven Healthcare Services (DDaHS)

  • In-App Solutions can be considered where existing Patient Engagement Tools already provide 24/7 patient registration, teletriage,
  • Health Management, self-care instruction support and a seamless appointment-setting experience!

[ 3rd Eye View:

C Medical Assistant Professional & Training Evolutions
Assist professionals, whether non-clerical administrative aides, MA’s certified training, scribes (clinical) coding, radiological tech for imaging diagnostic radiology department, may further optimize task delegation strategies

D, E
Optimized Administrative Support Role Evolutions Administrative Support Worker | Patient-centered Care #Administration #JobDescription. More [Content] from experienced administrative health care administrative & management role, #SupportRole (e. A Patient care coordinator / RN or even a professional Certified Professional to Medical office/ Clinic Administration

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Let your thoughts!

From a layperson’s perspective, I frequently see doctor shortages quoted in the news, and many patients experience long wait times and limited face-to-face time with physicians due to their heavy workloads. Midlevel roles were ostensibly created to fill this gap, and it’s understandable that physicians are upset, given the lower standards of medical and ethical knowledge midlevels have, especially when practicing independently. This subreddit is full of posts highlighting these concerns.

As a patient, I would prefer the medical accessibility gap to be filled by more expertly trained MDs. Midlevels are a fabrication of the insurance industry. However, it seems there is reluctance to create greater availability of MDs, largely because it could lower physician salaries. While the ethical argument about the risks posed by midlevels is often raised, MDs (or their associations) seem resistant to increasing their own supply (through restricted residency programs and convoluted matching for IMGs). So patients are left with two options:

a) substandard midlevel care, or
b) delayed or no medical care.

Perhaps I’ve misunderstood the medical ecosystem. Is it truly a zero-sum game? I’m curious to hear how MDs think this issue should be resolved. How do you envision a system where patient accessibility, safety, and outcomes are the priorities? If midlevels were eliminated tomorrow, what should fill the gap in accessible medical care that they currently occupy?

For context, I’m an aerospace/automotive engineer, and I understand the risks of eroding ethical standards and allowing undertrained individuals to practice in complex fields. Boeing is a recent case in point. We were also trained with public safety in mind, and now face an oversupply of  lesser-trained adjacent professionals bringing down our median salaries. Titling abuse has run amok in my field. I respect the tight control physicians have maintained over their profession and wish we had done the same.

Apologies in advance for the moderator bot—I've tried my best to use the correct language.

TLDR: Midlevels were created to address gaps in medical care due to an oft-quoted doctor shortage, but their lower training standards raise serious patient safety concerns. While more MDs could fill the gap, it seems there's reluctance to increase physician supply, possibly due to concerns about lowering salaries. Is it a zero-sum game where patients are left choosing between substandard care or delayed/no care? If midlevels were eliminated tomorrow, what solution would MDs propose to ensure timely, safe, and accessible care?



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