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Nurse Practitioners: Cheaper than Doctors, and Just as Effective

Why see a doctor for routine health care when a nurse practitioner can offer the same care at a lower cost? That’s the question raised by a recent post on Slate by Matthew Yglesias. He quotes from a roundup of studies on the quality of nurse practitioner care that gives them high marks:

Studies comparing the quality of care provided by physicians and nurse practitioners have found that clinical outcomes are similar. For example, a systematic review of 26 studies published since 2000 found that health status, treatment practices, and prescribing behavior were consistent between nurse practitioners and physicians.

What’s more, patients seeing nurse practitioners were also found to have higher levels of satisfaction with their care. Studies found that nurse practitioners do better than physicians on measures related to patient follow up; time spent in consultations; and provision of screening, assessment, and counseling services.

Nurse practitioners are also cheaper than doctors. They are reimbursed by Medicare at only 85 percent of their rate, and they charge insurance companies and individuals less. But only 18 states allow them to offer primary care to patients; the rest try to protect doctors from competition by limiting what nurse practitioners are allowed to do. Yglesias argues that relaxing these state restrictions would be an easy way to increase access to health care while saving costs.

Yglesias may soon get his wish. Sheer economic pressure will eventually begin to break down the guild-like structures in health care, just as it is doing in the legal profession. In an ideal world, everyone would like to see a doctor with the highest level of training. But given the current fiscal realities Americans will always prefer more and cheaper health care from less trained health professionals rather than “rationed” care from a smaller cadre of doctors, particularly when it comes to routine treatments.

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