But the need for more primary care is forcing a welcome reassessment of these policies. So 28 states are reportedly considering loosening the regulations for nurse practitioners, on the novel theory that any competent professional health care is better than none.
Private enterprise is already responding to what consumers want. Walgreens, for example, has established more than 700 retail health clinics staffed by nurses, nurse practitioners and other non-doctor professionals. CVS has its own version. The number of these facilities is expected to soar in the next few years.
You might fear that this sort of treatment is inferior to what you'd get from your personal doctor. Your doctor might agree. The American Medical Association, reports the Associated Press, warns that "a doctor shortage is no reason to put nurses in charge and endanger patients."
But put your mind at ease. A 2000 study published in the Journal of the American Medical Association found that where nurse practitioners have full latitude to do their jobs, their patients did just as well as patients sent to physicians. Other research confirms that finding, while noting that retail clinics provide their services for far less money than doctors' offices and emergency rooms.
Obviously, if you wake up with crushing pain in your chest or fall out of a second-story window, you'd be well-advised to see a specialist. But for common ailments that are mainly a nuisance, a physician may be a superfluous luxury.
Obama's health care reform rests on the assumption that expanding access demands a bigger government role. But even its supporters should be able to see that sometimes, it helps to get the government out of the way.