ACP policy emphasizes physician-led team care
State licensing bodies should allow the independent practice of medicine to be performed only by physicians, ACP stated.
ACP recommends that physicians should be the primary leaders of multidisciplinary team-based care models in a new position paper.
Physicians' training makes them most qualified to make advanced clinical decisions, and they are not interchangeable with other health care professionals, ACP states. The paper goes on to recommend that division of responsibilities within the team be guided by the best interests of the patients and that patients be made aware of the unique qualifications of all the team members. The position paper was published Dec. 26 in Annals of Internal Medicine.
The paper continues that state licensing bodies need to recognize the different skills, training, clinical experience, and demonstrated competencies of health care professionals. Only physicians should perform medicine independently, it says. Last, the paper recommends redesign of payment and delivery models and continued research to achieve the best outcomes for patients.
The paper concludes, “ACP reiterates that policymakers should reject efforts to allow nonphysician health care professionals to practice independent of the physician-led health care team and adopt strategies to ensure all patients have access to a physician trained to deliver whole-person, comprehensive, and longitudinal care.”
An accompanying editorial stated that much of the demand for other health care professionals has been created by a shortage of primary care physicians compounded by the needs of an aging population and that for-profit health care organizations may preferentially hire nonphysicians only for economic reasons.
“As ACP highlights, there is a huge gap in numbers of years and clinical exposure in training between physicians and other health professionals. In addition, the training for nonphysicians is not standardized and often depends on the availability of clinical rotations and preceptors,” the editorial said. “Too often, preceptors for clinical rotations must balance precepting students with full patient schedules. In some programs, master's-level [nurse practitioner] graduates have never had any bedside nursing experience, and many training programs are offered partially or exclusively online.”
In a second policy paper in the same issue of Annals of Internal Medicine, ACP called for barriers to participating in elections to be removed. ACP made recommendations about how to inform physicians, medical students, and other health care professionals about the links between electoral processes and health, encourage civic participation, and support safe and equitable access to electoral participation to advance health equity for both patients and health care professionals.
ACP recognizes that voting impacts health and health care and supports policies that ensure safe and equitable access to voting, opposing the institution of barriers to the process of voter registration and the act of casting a vote. Additionally, ACP supports the drawing of fair, representative, nonpartisan electoral districts and recognizes that partisan gerrymandering may exacerbate health inequities through the disenfranchisement of vulnerable communities.