Doc calls for expanding the scope of care

Expanding the scope of practice for staff members, such as nurses and medical technicians, might sound scary but it can be good for both them and your patients, says Fred N. Pelzman, M.D., a New York-based internal medicine physician.

Consider, for instance, that no patient wants to waste time sitting in your practice, waiting for their check-up to start. So what if you used that wait time to capture depression screening and medication reconciliation data? That's one place where you can get staff members more involved in patient care, according to Pelzman in his recent MedPage Today commentary.

Practices can certainly stand to improve their documentation of vaccine status, tobacco counseling, blood pressure interventions and conversations with patients about body mass index, says Pelzman. Still, it’s difficult to do that in a 15-minute patient visit.

Practices can use the patient wait time to capture this data. While it can be difficult to get doctors to capture all of this “stuff,” both nurses and medical technicians are eager to get more involved in patient care, he says.

“Our nurses are itching to do more. They want to provide actual care for patients, not just spend time on the phone doing prior authorizations and refills. They want to talk to our patients, care for them, give them advice, teach them about their disease, and really become part of the team. That has been missing in the ambulatory setting,” writes Pelzman.

Getting senior leadership at his practice on board with changing the “scope of practice” for nurses and medical technicians wasn’t easy. But it became clear that doctors weren’t capturing this quality data. Fast forward to today, when the rest of the staff are getting more involved in patient care--and doctors are happier and patients are healthier.