www.escambiacms.org MAY/JUNE 2014 VOLUME 44, NO. 3
BULLETIN Editors: Hillary Hultstrand, M.D. Erica Huffman, Executive Director
The Sharknado of Health Care Legislation
UPCOMING EVENTS Tuesday, August 12, 2014 | Rodizio Grill 5:30p Young Physicians Section Sponsors: Safe Harbor Tax Advisory, Catalyst CRE, Fisher Brown Bottrell Insurance, Southern Cloud Accounting, Dyken Wealth Strategies, McMahon & Hadder Insurance Sunday, September 28, 2014 | Hemingway’s on Pensacola Beach 11:00a-1:00p Women in Medicine Sponsors: Danna Gracey Insurance, Fisher Brown Bottrell Insurance, ProAssurance
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A number of health care issues — operation of trauma centers, telemedicine and expanding powers of nurse practitioners — have been bundled under a single bill that was up for House committee discussion in mid-April. The bill is so massive and so unwieldy, it is being to referred to affectionately as the Sharknado of health care legislation. The Florida House Health & Human Services Committee passed this megabill on April 10, 2014 that combines three prickly issues, in the hope that packaging them will make it harder for the Senate to kill or maim any of them. HB 7113 would protect private for-profit trauma centers, allow for independent practice for nurse practitioners and allow out-of-state doctors to participate in telehealth without a Florida license. The Florida Medical Association opposes the latter two. Such a package is sometimes called a “train” in legislative parlance. The idea of a train is that it’s a bunch of connected railcars, and it would be hard to remove one of them without causing them all to derail. As a practical matter, it means some lawmakers have to accept a proposal they don’t like in order to get one they really want. Regarding expanding the scope of nurse practitioners, proponents of the bill state that data from other states show there is no significant difference in outcomes between physicians and independent nurse practitioners in primary care. There are currently 16 states (plus Washington, D.C.) that allow nurse practitioners to provide primary care with full independence — that is, without a mandated supervisory relationship with a doctor. There is an excellent article called Think twice before
throwing doctors to the wind in an online source called Remapping Debate. The article points out some of the differences and why it Dr. Susan Laenger is difficult to measure the impact of independently practicing nurse practitioners. The URL is http:// www.remappingdebate.org/article/ think-twice-throwing-doctorswind?page=0,2&sf25139045=1 In discussing out-of-state practitioners engaging in telehealth with Floridians, there are objections to the bill’s lack of a requirement that they have a Florida medical license. Without that, state authorities could do no background check or fingerprinting. While all of us are still feeling overwhelmed by mandates of implementing EHRs and ICD-10 (though that was recently put off until October 2015), we still need to engage in current legislative debates as these will shape the world of medicine for our practices and our patients. First and foremost, we must advocate for legislation that is aimed at protecting our patients. Being an advocate for our patients is what drew many of us in to the field of medicine. I would like to thank Dr. Ellen McKnight and acknowledge that she has taken a lead as an advocate for doctors. If each of us step up to do just a little bit, we become a stronger voice for the needs of our patients.