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Updated Monday, February 25, 2013 at 06:01 PM

Number of doctors may not match need should Medicaid be expanded

By Letters Coordinator
The Seattle Times

Non-physician health-care providers will be indispensable

In his op-ed, “Are there enough doctors to expand Medicaid coverage?” [Opinion, Feb. 19], Dr. Nick Rajacich argues that as Washington considers expanding Medicaid under the Patient Protection and Affordable Care Act, we should figure out whether there are enough doctors and other caregivers to care for the potential 300,000-plus new patients.

His concern is shared by many of us who focus on Washington’s health.

A growing segment of our workforce that will continue being indispensable in the future of care is advanced-practice registered nurses (APRNs). Primary-care health-care providers are not exclusively physicians. APRNs already are critical to primary care in Washington, and will be vital to the successful implementation of the Affordable Care Act.

Of the approximately 5,200 Washington APRNs, many have their own primary-care practices in Washington; some work in partnership with physicians; others are certified nurse midwives and certified nurse anesthetists.

Washington is one of 13 states where APRNs can practice independently, without oversight or direction from physicians. Research confirms that APRN patient outcomes and patient satisfaction match that of physicians.

The Medicaid expansion is an opportunity to extend coverage to many more people in Washington, and it can be successful in an environment of coordinated, effective care.

--Linda Tieman, executive director of the Washington Center for Nursing, Tukwila


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