Fighting to preserve the medical cartel

The American Medical Association (AMA) has been quite transparent about its commitment to preventing America’s health care consumers from choosing to get care from non‐​physician health care professionals. The organization actively opposes legislative attempts to expand non‐​physician health providers’ “scope of practice.” It has long fought against state laws that permit nurse general practitioners (NPs) and board‐​certified family practice nurse practitioners (FNPs) from providing primary care independently from medical doctors, arguing that it would lead to higher costs and reduced safety for patients. It is hypocritical for an organization representing professionals who swear an oath to respect patients’ autonomy to presume to control patients’ choices of health care providers.

Last week the AMA trumpeted a new working paper published by the National Bureau of Economic Research that concludes, “Nurse practitioners (NPs) delivering emergency care without physician supervision or collaboration in the Veterans Health Administration (VHA) increase lengths of stay by 11% and raise 30‐​day preventable hospitalizations by 20% compared with emergency physicians.” The study used quasi‐​experimental variation to study the patient outcomes and utilization costs between nurse practitioners and emergency physicians rendering care to patients in Veterans Health Administration hospital emergency departments from 2017 to 2020.