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An NP Goes to Washington

An NP Goes to Washington

Scrubs Magazine

Scrubs: What are some of the barriers that are currently keeping NPs from performing as primary care providers?

Mona: Recognition of NPs as primary care providers is a mandate that should be implemented. The language in the healthcare bill delineates one profession from another, what healthcare providers can and can’t offer. This creates a false barrier. Making sure that NPs are included is very important.

Another thing is that when patient care is performed by an NP, it’s sometimes billed “incident to” the physician. So sometimes you don’t “see” care being provided by NPs. NPs should: 1) be recognized by insurance companies, 2) own the numbers and 3) be included in all legal rules and regulations.

After what just happened in Massachusetts, we’re sort of back to square one and how do we negotiate. I do think, though, that in the future, NPs will be primary care providers. That’s what they’re trained to do, so let’s use them the way they’re trained. I’m a big NP fan, of course [laughs]. I think they’re not utilized in every state or by insurance companies in their ability to benefit patients.

Scrubs: How do you think the new bill might impact the community where you work?

Mona: We treat a lot of working poor who are really hard workers and do try their best to pay their bills. I do get some patients who will pay their bills with zucchini. I used to be one of HHS Secretary Tommy Thompson’s health fellows. They all looked at me like I had five eyes when I told them about patients paying with zucchini. So on the second or third meeting, I brought in the zucchini so the policy people could see!

Anyway, where I work, we are a federally qualified health center, so we do offer sliding scale fees to those we see. Because we are a smaller community, we always have the option to look at the fees depending on the needs of the individuals and families. We see everybody, regardless of their ability. We’re such an integral part of the community that it’s different from many places. The option to buy affordable insurance is probably a good one. How it will actually affect these folks? I can’t really predict that.

Scrubs: Would you like to be invited back to the White House?

Mona: I would love to go back. I would love to help them understand what people in the trenches really experience. The other thing is to really focus our healthcare on prevention. Spending so much of our research funds on the patient’s last two months of life doesn’t seem valid. That’s where the majority of dollars are spent.

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