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Medical malpractice and doctor shortages

If anyone from Pittsburgh has recently gone to the doctor's office, they may have noticed that more and more their cases are being handled by a physician assistant (PA) or nurse practitioner (NP). The reason why these individuals are playing such a significant role is because there is a shortage of physicians that can see patients on a day-to-day basis.

There are approximately 85,000 PAs across the nation, and about 155,000 NPs. Every state has different laws concerning what a PA or NP can do, but the increase of those hired to take on these positions has increased dramatically over the past ten years.

There are dangers in using these professionals, however. A failure to diagnose symptoms of a pending stroke of a 44-year old man that was believed to partially have come about because of the actions of a PA resulted in a $217 million medical malpractice verdict - the second highest verdict of this type in history.

Where doctors' offices and medical clinics run into problems concerning these employees is when a PA or NP is inadequately supervised, or when one of these individuals performs services both beyond the scope of their employment and their level of training. Ultimately, a doctor will be held accountable by attorneys and judges when a PA or NP makes a mistake that results in an injury.

For example, one NP prescribed an antibiotic for a child suffering from a sore throat. The mother of the child called the NP a couple of days later stating the sore throat had not improved and, instead of contacting a physician, the NP then prescribed another antibiotic. It turned out the child was suffering from undiagnosed meningitis.

There are a number of ways that hospitals can avoid liability for the actions of PAs and NPs. The best way to do it, however, is to make sure these employees are specifically trained, that written protocol is in place outlining what a PA or NP can and cannot do, and make certain adequate supervision is in place.

Source: Medscape Today, "Malpractice Risks With NPs and PAs in Your Practice," by Mark Crane, Jan. 3, 2013

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