New Hampshire Votes on a New Healthcare Provider as March Ends
By Robert M. Blumm, MA, PA, PA-C Emeritus
In a few short days, one of the northeast states is going to vote on having non-residency medical graduates licensed in N.H. to provide medical care because of their shortage of physicians. There are a plethora of PAs and NPs who could continue to grow and provide this care, but they were not approached.
I only wish that the legislature in N.H. would have looked at the FMG program at Harlem Hospital initiated by the wife of the first president of the AAPA, Bill Stanhope, where a test was given before and after their participation in an accelerated PA Program. All participating FMGs failed on both pre and post-testing. During my presidency of NYSSPA, this data led to the State Board of Medicine writing a law into the NYS law: an FMG could not apply for a position as either a PA or physician. The Harlem Hospital study proved the incompetence of this type of provider. Dana Stanhope agonized in putting this accelerated program together, but the conclusion was discouraging, to say the least. New Hampshire will now place their citizens at risk while there is a large supply of PAs and NPs that could fill the needs of their state. This is not unlike us in the infancy of our profession. Physicians said that we could never care for their patients and neither would they accept us. We were formally trained in similar fields and worked feverishly to start and maintain our professional status and today, fifty years later, are a force to be reckoned with. Good luck N.H. and let's see the increase in medical malpractice.
Where can these new providers become entangled in medical errors? The main area would be in failure to diagnose. An insurance study was performed on NPs and this was the area they were most implicated in, failure to diagnose cancer and heart disease. My assumption is that if and when these newly minted clinicians become licensed in N.H. that they will be missing a diagnosis in many cancers, many types of heart disease; they will mistake severe back pain for a sprain instead of an aortic aneurysm, a DPT for a leg cramp an overuse injury' abdominal pain for an ectopic pregnancy and abdominal aortic aneurysm for gastroenteritis Oral or dental pain will mislead them from diagnosing a Ludwig's Angina and a SAH will be misdiagnosed as a migraine headache and the patient will never recover. These are just a few of the areas of concern and we could add dermatological diseases and melanomas, ophthalmological diseases and retinal melanoma and retinal detachment, head and neck cancers instead of enlarged lymph nodes and osteosarcomas instead of fractures.
How are these clinicians going to be credentialed? What will their limitations be? Will they get prescribing privileges and who will insure them outside of an institution? What will this do to the rates of the hospital insurance carrier and how will it affect PAs and NPs?
These questions bring me back to my age-old argument that we, as responsible providers, need to protect ourselves, our careers and our families by purchasing a professional liability insurance policy with our name on the title page. This will be our anchor in a time of a storm. I suggest the AAPA endorsed company, CM&F, who offers both claims made and occurrence and is A++( superior) rated by A.M. Best. Students and first-year clinicians receive discounts and this policy allows the insured to moonlight. What more can we ask for in these days?