Your voice matters. Join the fight!

---

A physician's personal stories and testimony are well-respected tools in this conversation. Please use the below email message as a template or baseline for constructing your personal message to legislators.

 

Dear (Senator or Representative) _______,

If the Healthcare Market Reform is formed pursuant to S.885 and if it is charged with studying the wisdom of increasing scopes of practice for various professions in South Carolina, I want to make sure you are aware of how vital physician-led healthcare is to protect patient safety, keep healthcare costs from increasing even higher, and to honor patient preferences.

Every member of a healthcare team is essential. Diverse training, individual roles, contributed talents, and shared accountability are necessary for each party to operate together as a whole. However, when there is a deviation from the plan, things go wrong, new or complicated scenarios arise, or split-second decision making is required, it is essential that the most highly trained member – the physician - is leading the team to avert disaster, keep costs as low as possible, and maintain the highest quality of care.

Current law allows nurse practitioners (NP) and physician assistants (PA) to perform medical acts consistent with and beyond their formal training and experience as long as their practice is consistent with the collaborating or supervising physician’s training and experience. NPs and PAs have been advocating to remove the physician as the leader of the healthcare team, but these basic patient protections should never be removed from South Carolina law. No other southeastern state has taken this very liberal step, either.

Multiple national studies show that physician-led care is higher quality and lower cost. Specifically, those studies show the following:

• Non-physicians needed 2 times the number of biopsies to screen for skin cancer.
• Patients were 15 times more likely to receive an antibiotic from a non-physician.
• X-ray ordering increased 441% among non-physicians.
• In opioid prescribing, 6.3% of nurse practitioners prescribed opioids to over half of their patients compared to 1.3% of physicians.
• Patients with non-physician primary care providers had $43 higher spending per month compared to those who had a physician, which could translate to $10.3 million more in annual spending.
• In an emergency department, nurse practitioners use more resources and achieve worse outcomes than physicians, especially when dealing with complex patients.

Physicians are by far the most educated and experienced member of the health care team:

• PHYSICIANS receive 4 years of medical education, 3-7 years of residency, and 10,000-16,000 hours of training. All physicians receive hands-on training.
• APRNs receive 2-3 years of healthcare education, no residency, and only 500-720 hours of training. 60% of APRN programs in 2019 were mostly or completely online.
• PAs receive 2-2.5 years of healthcare education, no residency, and 2,000 hours of training (only 12.5-20% of a physician's training).

The American Medical Association mapped the locations of primary care physicians and nurse practitioners nationwide in 2013, 2018, and 2020. Each time, the results showed physicians and nurse practitioners tend to practice in the same areas of the state – regardless of the state scope of practice laws.

This shows that despite promises, nurse practitioners have not moved to rural areas even in states where legislators removed physician supervision/collaboration.

Proven reforms that expand access in rural and underserved areas are telehealth expansion, increasing residency positions, loan forgiveness programs for physicians in rural and underserved areas, and programs that encourage students from underserved areas to pursue medical school.

Finally, nationwide, 91% of patients say a physician’s education and training are vital for optimal care. Nationwide, 3 out of 4 patients would wait longer and pay more to be treated by a physician.  Nationwide, 95% say it’s important for a physician to be involved in their diagnosis and treatment.

We appreciate your commitment to healthcare access and quality for SC citizens and ask that you resist any efforts to eliminate physician-led healthcare in  South Carolina. Please do not hesitate to contact me if I can answer any questions.

Sincerely,

(your name)