Newly introduced legislation promotes an antiquated model of care, breaking up the team – Coalition promotes collaborative care team model as foundation for success
Trenton, NJ – Today, the Access to Care Coalition, which is comprised of 19 physician specialty organizations with more than 31,000 New Jersey physician members, launched a campaign to highlight the importance of making sure doctors are directing and involved in health care decisions.
Beginning this week, the Coalition’s campaign, which includes a relaunch of its website and social media, as well as digital ads, will emphasize the importance of maintaining a relationship with your doctor, outline the benefits of team-based care, and shine a light on the value of physician collaboration and supervision of non-physician members of the team, including advanced practice nurses (APNs) and physician assistants (PAs).
“We have all seen the evolution of a traditional medical practice from Marcus Welby, MD, working by himself, to physician practices of today, which include doctors working with a team of health care providers, including APNs and PAs. Team-based care offers patients the ability to receive all levels of care based on what they need at that time and allows non-physician providers the ability to collaborate and consult with doctors within the same practice and often right at the time of the patient’s visit. While APNs and PAs are playing an increasing visible role, physicians are leading the team that delivers care to patients and playing an essential role, whether it’s a well-visit or post-op surgical visit,” said Michael Cascarina, MD, board chair, New Jersey Academy of Family Physicians
Team-based care is consistently recognized as a best practice to provide the highest quality care at the lowest cost possible while improving patient outcomes. A 2021 article published in Health Affairs examined electronic health record data and found that teams of physicians and other non-physician providers outperformed solo providers. Furthermore, according to American Medical Association, 95 percent of voters think it’s important for a physician to be on their health care team with their experience leading their treatment and diagnosis.
However, an effort is underway in Trenton that would break up the care team by permitting APNs to see patients in their own practices without the safety net of working with a doctor and other non-physician providers in the proven team-based model. Newly introduced legislation in the Senate and Assembly, S-1522/A-2286, would allow APNs to see patients without having a collaborating physician and a joint protocol agreement that sets out the parameters of practice to prescribe medications agreed upon by the APN and the doctor.
“As physicians we understand the value of team-based care and what we can achieve together for the benefit of the patient, and not just what each individual health care professional can accomplish independently,” said Steven Orland, MD, president of the Medical Society of New Jersey. “S-1522/A-2286 does not address workforce challenges facing patient care in New Jersey. These bills move away from team-based care and focus on independent practice of advanced practice nurses. In an era where New Jerseyans need integrated, team-based care for complex medical and surgical conditions, moving to siloed care will undo the progress health care teams have made. For decades, physicians across New Jersey have embraced the team-based approach, working alongside advanced practice professionals such as PAs and APNs to extend access, improve quality and reduce the cost of delivery. In an era of both constant innovation in clinical care and workforce and cost challenges, New Jersey policy leaders should be promoting cost-effective, patient-centered care, not care centered around independent practice models.”
Additionally, the bill specifically allows APNs to administer anesthesia and manage anesthesia services without supervision of an anesthesiologist, which exposes patients to unnecessary risks. Studies show that APNs practicing independently has resulted in an 8.7 percent increase in patient spending on surgery costs and patients being 80 percent more likely to be hospitalized after outpatient surgery. Therefore, independent practice doesn’t improve access to care or decrease costs but can have dire consequences for the patient.
“We are committed to the value and benefit of this team approach and are dedicated to how important it is for patient safety. Every time it has been studied, the value of physician-led care is in the best interests of patients and has been shown to improve access, costs, safety and quality of care,” said Amanda Burden, MD, president of the NJ State Society of Anesthesiologists. “We are very concerned that anyone would want to deny patients the right to having a physician for such a critical moment in their health care.”
The Coalition will also work to address barriers to APNs practicing at the top of their education and training within in a team-based practice, and work with the proponents of this legislation to resolve such barriers, with the ultimate goal of improving collaboration between APNs and doctors leading to better outcomes for patients.
For over a decade, the Access to Care Coalition has worked together to promote access to quality medical care for patients.
Members of the Access to Care Coalition include:
- Medical Society of New Jersey
- New Jersey Orthopaedic Society
- New Jersey State Society of Anesthesiologists
- New Jersey Psychiatric Association
- Radiological Society of New Jersey
- New Jersey American College of Emergency Physicians
- New Jersey Society of Plastic Surgeons
- American College of Physicians – NJ Chapter
- New Jersey Academy of Family Physicians
- New Jersey Academy of Ophthalmologists
- New Jersey Association of Ambulatory Surgery Centers
- American Academy of Pediatrics – NJ Chapter
- New Jersey Neurosurgical Society
- New Jersey Association of Osteopathic Physicians and Surgeons
- New Jersey Society of Pathologists
- New Jersey Section of American College of OB/GYNs
- New Jersey Society of Interventional Pain Physicians
- NJ Patient Care and Access Coalition
- Urologist Society of New Jersey
For more information at the Coalition and its efforts, visit: www.accesstocarecoalition.com.