tag:blogger.com,1999:blog-7171420941776673660.post6635744071692028032..comments2024-03-28T02:29:13.507-07:00Comments on Legal Ruralism: The rural health landscape (Part I): Women's health—A snapshotLisa R. Pruitthttp://www.blogger.com/profile/16469550950363542801noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-7171420941776673660.post-69717151464582662992017-03-13T22:35:02.066-07:002017-03-13T22:35:02.066-07:00I thoroughly enjoyed this post! I knew little abou...I thoroughly enjoyed this post! I knew little about the doctor shortage (or, perhaps more accurately, acute mismatch of practice areas and those interested in practicing). Of course, it would make sense that doctors have less interest in being generalists/internists, and more interest in highly specialized and more lucrative fields. It is also the classic brain-drain story of rural areas lacking in professionals. (I must admit I have, in my past, watched a cheesy television show about a big-town specialist doctor who swallows her pride to go work in rural Alabama as a general practioner: https://en.wikipedia.org/wiki/Hart_of_Dixie, but I didn't realize that the premise was so accurate.)<br /><br />I also knew little prior to this post about how great NPs (I've known many in my life and I deeply believe in their work) could solve possibly solve this problem just by being given more autonomy. I stumbled across this article about studies of Nurse Practitioners improving patient outcomes, often more cost-effectively: http://www.pacnp.org/news/277542/Five-New-Studies-Nurse-Practitioners-Expand-Access-to-Health-Care-Lower-Costs-Improve-Outcomes.htm<br /><br />I very much look forward to the additional installments of this post, particularly with regard to your friend who is making a conscious choice to take her medical work into rurality.<br /><br />Thank you for such a thought-provoking topic!Anonymoushttps://www.blogger.com/profile/03192921782376440109noreply@blogger.comtag:blogger.com,1999:blog-7171420941776673660.post-29817222805953015582017-03-12T14:59:17.191-07:002017-03-12T14:59:17.191-07:00I enjoyed your post! This is a topic I am personal...I enjoyed your post! This is a topic I am personally interested in because I see a certified nurse-midwife for the majority of my maternal care. The nurse-midwifes I have talked to in California are very interested in passing legislation to lift some of the practice restrictions you mentioned. In fact, one California state senator has fought to expand the scope of nurse practitioners’ independence in recent years, but so far this has not been successful (http://californiahealthline.org/news/california-nurse-practitioners-lose-battle-for-independent-practice-again/). <br /><br />On a previous blog post, I commented that physical physician supervision of nurse practitioners is often quite limited. Although the nurse practitioner may be under the supervision of a doctor, the doctor may only check in 2-3 hours per week. This news article provides a good example of what that relationship might look like (http://www.scpr.org/news/2015/07/17/53160/doctors-supervise-but-most-nurse-practitioners-wor/). <br /><br />Because physician supervision is so limited, even states like California that currently have practice restrictions for nurse practitioners and certified nurse midwifes may benefit from increasing their use of mid-level professionals. Physicians could be available for consultation by phone or internet, and advances in telehealth may aid in this process (of course, there is always the added issue of access to broadband for remote rural areas). But like you mentioned, increasing the use of nurse practitioners is only part of the solution. This would not address the larger, more complex issues of rural access to healthcare.K. Harringtonhttps://www.blogger.com/profile/10279354119401616344noreply@blogger.com