Hopkins CEO: Nurse practitioners could reduce need for more docs

Contrary to the opinions of many medical prognosticators, Ed Miller, dean of the School of Medicine and CEO for Johns Hopkins Medicine, believes that more doctors are not necessary to handle the influx of patients sure to hit once health reform fully kicks in. Instead, he sees an opportunity to call on many other caregivers--nurse practitioners, physician extenders and technicians, for example--to step up and fill in the gaps, according to a recent interview with The JHU Gazette

"I'm sure there are many places in the country that will [need more doctors due to reform], but I do believe better use of ancillary people could meet many of our needs," Miller says. "If you think about it, the armed forces with corpsmen have been able to figure that out. I was in the Army for a few years, and I could tell you that the corpsmen deliver very fine care to a lot of people, but we used ancillary people perhaps more effectively than we do now." 

Furthermore, Miller believes that the payment system is to blame for a lot of the healthcare woes the U.S. currently faces. If doctors were to receive monthly premiums to care for patients, he says, perhaps they would be more inclined to delegate responsibilities. 

"I only get paid if I touch you as a physician," Miller says. "I think if the payment system were changed, we [could] figure out a way to more effectively use people so we [have] the right person helping the patient at the right time." 

Miller also shared his thoughts on personalized medicine, and what he sees as the biggest issues in healthcare today. He calls the former "inevitable," comparing it to the computer chip industry in terms of costs eventually dropping. 

With regard to the latter, Miller believes diabetes and obesity to be the next big challenge, specifically childhood obesity. 

"You just think about these kids who are pre-diabetic already and are going to have significant weight and then maybe cardiovascular disease," he says. "They are going to have strokes. They are going to have heart attacks at young ages. And then there's the whole issue of productive lifestyle. 

"Are they going to be disabled because of their illness?" 

To learn more about Miller:
- read the full interview in The JHU Gazette