Can’t We Agree: You Do Need a Doctor for Surgery

David Williams

3/11/2014 9:45:00 AM - David Williams

Like the furry critters in Whac-A-Mole, the consequences of Obamacare keep popping up and rearing their ugly heads. When faced with a study that suggested doctors would opt out of accepting Obamacare insurance plans, leading to fewer qualified providers, Obamacare’s chief architect, Dr. Ezekiel Emanuel, let it slip that the folks behind the law think “you don’t need a doctor for every part of your health care.”

Now, there are certainly qualified medical practitioners that can administer flu shots, take a patient’s blood pressure, etcetera – under the supervision of a medical doctor. But unfortunately for an administration already facing tanking approval ratings due to the Obamacare’s massive unpopularity, survey data clearly shows that patients want – and need – trained medical doctors providing their health care.

The push to redefine medical care is not just coming from folks like Dr. Emanuel at the top. State legislatures are muddying the waters by considering measures to expand the procedures that these medical practitioners are allowed to perform. A glaring example of this is in Tennessee where a measure that would allow optometrists to inject anesthesia and operate with a scalpel on the eyelid. California and Louisiana proposed similar legislation in 2013.

To clarify, even though you may call your optometrist “doctor,” they did not attend medical school or complete a residency or surgical internship that would qualify him to perform scalpel surgeries around your body’s organs. Those that did complete medical school and training – ophthalmologists – are trained to perform surgeries in and around the eye and, as importantly, have the necessary training to diagnose problems correctly and handle complications that may arise from these complex procedures.

What proposals like Tennessee’s amount to is erosion of quality of care in the name of providing increased access and lower costs. But even those promises are false. Doctors argue that part of their training is not just how to perform procedures, but also when to – and when not to – perform them. Patients that are misdiagnosed and mistreated in the hands of untrained practitioners will require more care and additional expense through the life of their illness.

That is good neither for the patient nor the system.

Tennessee isn’t the only state considering these “scope of practice” expansions. Last year, both Louisiana and California were considering allowing optometrists to perform more complex procedures. Both of these states ended up abandoning the bills at the end of their respective legislative sessions. But, unfortunately, bad ideas don’t just go away, they wait for another year and this issue will probably make another appearance this year.

States are under pressure from Obamacare’s fiscal strains to make improvements to health care delivery and accommodate the newly insured. And redefining who is a doctor is an easy way to get more “care” out there with the stroke of a pen.

However, as with most quick and seemingly easy fixes, this one offers a false choice and bad solution. The real way to improve health care, doctors say, is through long-term improvements and investments aimed at training more medical doctors. That is a rising tide approach to health care. It’s not a quick solution, but it is the right one.

Of course, there is one quick way to ease the health care burden these states are struggling to cope with – repeal Obamacare. But until 2016, that road looks improbable. And in the next three years, optometrists will only increase their lobbying assault on state legislatures. It is up to legislators across the country to resist quick fixes that jeopardize access to quality healthcare for Americans.