Janice Boughton, MD, author of the blog Why is Americn Healthcare So Expensive, suggests physicians should consider shifting procedurals work to nurse practitioners and physician assistants.

Procedures are very expensive.  A cataract surgery, for example, requires less than one hour of physician time and is reimbursed at $1,500.  Boughton suggests that teaching nurse practitioners and physician assistants to preform more complex medical procedures could significantly drive down the cost of healthcare for patients.  Procedures such as cataract extraction and colonoscopies are relatively straightforward and could be mastered by nurse practitioners.  Boughton points out that although this idea may sound unsettling, in developing countries with few physicians, laypeople are trained to do medical procedures with excellent outcomes.  She believes that nurse practitioners and physician assistants with special training are qualified to perform these types of procedures.

A trend in this direction would be very unpopular among physicians as these routine procedures are high-paying.  However, with the ever-increasing cost of healthcare in our country this move must be considered.  Nurse practitioners and physician assistants are qualified ad ready to be trained to do higher level procedural work.

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