The American Interest
Analysis by Walter Russell Mead & Staff
NHS Gives Non-Docs the Power to Prescribe

HospTech

For once, some good news from the British National Health Service: physiotherapists and podiatrists will now be allowed to prescribe medication for their patients without doctor supervision. BBC:

Care and Support Minister Norman Lamb said the move would not only benefit patients by making it more convenient to get treatment, but would also free up valuable GP time….

Phil Gray, chief executive of the Chartered Society of Physiotherapy, said: “This is a landmark moment that will lead to patients receiving faster, more effective treatment for their condition.

The crucial bit here is the part about freeing up time for GPs. It’s obvious that patients stand to benefit from the sharing of medical power: not only can they get the medication they need easier, but allowing non-doctor providers to assume more responsibility will reduce costs throughout the system. But doctors will benefit as well. With the more routine tasks passed along to other professionals, doctors can be freed up to devote more time to complex cases and patient interaction, both of which were probably what attracted them to the medical field in the first place.

As computer-assisted medicine advances, more of this should be possible, and it will make health care in the UK better for all the actors involved.

[Hospital technology image courtesy of Shutterstock]

Published on August 20, 2013 2:40 pm
  • docwhocuts

    this is a good idea?

    no counter point?

    yeah, no bias here.

  • Boritz

    Let’s empower them to perform amputations next. Does it really require four years of medical school and a five year surgical residency to saw bones? Think of the savings.

    • MichaelKennedy

      You first. How about your brain surgery ? Much cheaper. If you think that hasn’t occurred to the Obamacare folks, you’ve got some surprises coming. After all, those automated landing systems work so well in airliners. Oh wait…

  • Kelly Hall

    It’s already happening here. PA’s (Physician Assistants) already have the authority to prescribe drugs. These are the folks you’ll be seeing under Obamacare, not doctors.

  • Kevin Fleming

    It busts the MD guild, which needed busting. But it also increases the burden on the patient to understand how much training went into writing that Rx. If you think the NHS will will protect you from therapeutic errors by a podiatrist, well, good luck with that.

  • Dantes

    I am a medical doctor…radiologist…and this is a pipe dream. There is a reason medical school and training takes so long. The non physicians who are being graduated to physician status rely upon the statistics generated by the fact most people don’t have serious illnesses. However, most serious illnesses present as “routine” cases, a distinction which can only be made after the fact.

    Nurse Practitioners and other allied health practitioners tend to order far more tests and do not know their limits. It is good for the business I am in, but not good for patients and won’t reduce health care spending a bit.

    In addition, NP and other allied health practitioners don’t know what they don’t know, and love protocols…which are dictated by the state with the objective of saving money. An individual patient’s best interests come second.

    • http://www.agoyandhisblog.com/ AGoyAndHisBlog

      Also see the current trend to allow Licensed Social Workers to diagnose mental illness – precluding the need for a visit to an expensive psychiatrist or psychologist – by simply selecting symptoms in a (computerized) DSM-V. Next step: they’ll also be prescribing meds.

      The statists destroyed education a couple decades back, destroyed accountable government decades before. Now they’re destroying health care.

      Not with a bang, but a whimper.

  • West Texas Intermediate Crude

    I am a board certified physician, but I am in favor of this- in fact, I’m in favor of making just about all meds over the counter. People should be free to do to their bodies whatever they want, just as they are free to do their own taxes, their own electrical work, cooking, and hair. If a person is interested in diagnosing and treating himself, and is willing to accept the consequences of being wrong, it’s not my business to interfere. Just as a person is free to do his own tax return, or consult with a bookkeeper, accountant, tax lawyer, or cousin down the street, that same person should be free to cruise the net, talk to his neighbor the nurse, consult a homeopath, or follow the traditional route and spend a lot of money to see me and get my guidance.

    This system works only in a capitalistic medical system- where if you mess up, you pay up. In our socialized system, it would be a disaster (we are headed that way now).

    • teapartydoc

      Medical licensing by the government should be eliminated. Our med school and post-graduate credentials should be available in the office and on-line, and all drugs should be available according to arrangements worked out between producers and sellers with a privatized form of the FDA. There should be no BATF or DEA. Things are coming full circle for organized medicine. The monopoly arrangement worked out between the government and the AMA a hundred years ago no longer provides doctors with the benefits of the monopoly, only the burden of having the payer call the piper’s tune. It’s time to get out of an arrangement that no longer works.

  • Craig Good

    Ask a pharmacist, and you’ll likely hear that doctors are barely qualified to prescribe medications as it is. Unless there’s some serious restriction as to exactly what drugs non-doctors can prescribe, this seems like a very bad idea.

    • teapartydoc

      Then it makes no sense that we beat the pants off the pharm students when they are matched up with us in classes.

      • Craig Good

        Heh. In any case, the point is that prescriptions shouldn’t be made by amateurs.

  • http://www.agoyandhisblog.com/ AGoyAndHisBlog

    HTH is this “good news”????

    Oh wait.

    It’s good news for the pharmas, since this policy means an explosion in prescriptions.

    It’s good news for insurance companies, since it means that a visit for an Rx requires a visit to a lower-paid practitioner (i.e., reimbursement for the same service is reduced, while premiums continue to rise).

    It’s good news for statists, because the more people on some drug, the more government can restrict public behavior (e.g., ‘oh, you’re on Xanax? No concealed carry permit for you.’ Yes, I understand that this is moot in the UK, but you get the point.)

    Sorry, just had to think about it…

  • Alec Bell

    Let’s clarify here. What is being offered is that non-medical professionals will be allowed to prescribed specific (to their specialist area) and extremely limited medications. This has been around for while with nurse prescribers ‘allowed’, under assumed medical supervision (supervision from the golf course), to prescribe paracetamol (acetaminophen), band-aids, etc.

    From the pro point of view it would seem a no brainer. Why waist a valuable clinicians time (and let’s be honest here what usually occurs is a nurse/physio calls in a junior doctor and then tells them what to sign for – including what the dose, time, interactions are, and sometimes how to spell it). Then, Medicine has been a closed shop for far too long – think limited medical school places, training placements – to maintain the high incomes of those oh so rare specialists.

    From an anti perspective this will, like so many other ‘initiatives’ (think nurse endoscopists, central line insertion – alll with better outcomes than their medical colleagues by the way) will be used as an ‘excuse’ to cut the numbers of doctors. As with everything, ‘follow the money’.

    Personally I think it’s another step in the right direction, even if for the wrong reasons, but hope the numbers of doctors here will be, at least, maintained.