By MAGGIE MENDERSKI
Herald-Whig Staff Writer
As the medical community braces for an increase in insured patients, the Illinois Legislature has blocked a request from nurses, dentists and psychologists for more authority to make medical decisions.
Hundreds of thousands of Illinois residents will be newly eligible for health insurance next year under President Barack Obama's healthcare law. Those patients will seek primary care providers.
Nurses and other medical providers argued they could ease the burden, but in lobbying hard to defeat or gut those proposals, the Illinois State Medical Society argued they lacked proper qualifications.
"From the position of safety, we want to make sure no one is practicing beyond their abilities," Dr. Eldon Trame, president of the society which represents more than 11,000 doctors in the state, said.
The society opposed allowing advanced practice nurses the right to practice independently without written agreement from a physician.
Pam Brown, president and chief executive officer of Blessing-Rieman College of Nursing, said this wasn't an unexpected block for the nursing community. She explained that advanced practice nurses are often challenged on their level of education and their abilities when compared to physicians.
A study published in September-October 2011 issue Nursing Economics reviewed the effectiveness of advance practice nurses from 1990-2008. The study shows that patients of advanced practice nurses often experience similar or better outcomes when treated by a nurse instead of a physician.
Brown said the safety claim is unwarranted.
"We need physicians doing what they do the best, but we need to utilizing nursing to its full extent too," Brown said.
Brown noted the newly insured patients boost the need for healthcare workers as a whole, not just physicians. She said utilizing teamwork among healthcare professionals will produce the best outcomes for patients.
"None of us will do this in isolation," Brown said. "It's going to be more of a team."
Dr. Ron Johnson, of Pike County Family Practice in Pittsfield, echoed that need for teamwork to combat the medical professional shortage. In one-fifth of Illinois counties, a widespread shortages of primary care doctors exists. Another 200 pockets of Illinois also have shortages, both in urban and rural areas. Johnson said attracting new doctors to a rural area like Pittsfield is not an easy task.
Johnson estimated there is one health care provider for every 3,000 people in the Pike County area.
In his ideal medical landscape, that number should be one provider for 1,500 to 2,000 people.
While Johnson expects Illini Community Hospital and surrounding clinics to ease the surge of newly insured patients, he also is bracing for the shortage.
"There's going to be a shortage if people behave how we expect them to behave," Johnson said.
He noted it takes time to provide quality care to patients. Johnson said his patients need someone to discuss the importance of traditional care such as maintaining a healthy weight, quitting smoking and staying up to date on vaccinations. He explained giving patients the time they deserve requires medical professionals working together and practicing to the full-scope of their ability.
"So many people need to hear it from the doctor," Johnson said. " I don't think the information is any more valid from my lips than from the lips of my nurse."
The Illinois Medical Society also pushed to remove language from the from the bill that would allow dentists administer flu shots and immunizations. Johnson didn't anticipate a shortage of qualified individuals to administer injections for the Pike County area.
Dr. Richard Wright, former president of the T.L. Gilmer Society for local dentists and current president of the Adams County Health Department, said dentists have the skills to give injections.
Wright, personally, would prefer to provide those services through a clinic or the health department rather than in his own office.
"I consider that to be outside of the scope of our practice," he said.
The medical society argued that dentists don't have enough training to safely vaccinate patients with chronic illness or allergies. The dental society plans to bring the issue to lawmakers again but focus narrowly on flu shots, noting that the Affordable Care Act will increase the number of patients eligible for free flu shots and increase the need for professionals that can give them.
Wright recalled the H1N1 outbreak four years ago when individuals eager for the vaccine waited in lines that wrapped all the way from the health department to the courthouse. During that time, trained dentists and pharmacists helped administer the vaccine in parts of the country.
"I'm quite sure if there was an epidemic everyone loosens up the rules," Wright said. "I wish more people in my profession would have volunteered."
The Associated Press contributed to this story.