SC Medical Association’s Bullard: Teamwork is key to high-quality health care

During my 40 years of medical practice, I have had the opportunity to witness the benefits of the team-based approach to health care. While I was in the military, my training was enhanced by senior physicians and nurses (many of whom out-ranked me) as they mentored and shared their experience. Later, I had the opportunity to train physician’s assistants who came from the Army corpsman enlisted ranks.

When I entered private practice and had the chance, I employed an advanced-practice nurse. She along with my two office nurses allowed me to provide services to a large number of previously under-served obstetric and gynecologic patients. We even offered semester-long clinical rotations for advance-practice registered nursing students from both Clemson and the University of South Carolina Schools of Nursing in our office. To be able to provide even a small portion of their clinical training was a blessing. These young women were preparing to join the health-care teams in their communities, working with physicians’ supervision, under a well-defined structure, protocol-driven and endorsed by both the S.C. Board of Medicine and the S.C. Board of Nursing.

Throughout South Carolina, primary-care physicians provide access to quality health care to the folks of their communities. Working with advance-practice registered nurses and physician’s assistants, the practices provide a team-based approach that allows formerly under-served patients to have a medical home. The shortage of physicians in some areas is recognized, and the medical schools and training programs of the state’s universities and larger hospitals are geared up to alleviate this problem. But we must insist that the care available be of the highest quality, based on evidence-based concepts and guidelines.

For the past two years, in my role as medical director for the Midlands Mission, I have witnessed the societal benefits of collaboration by all members of a dedicated group of health-care providers — physicians, nurses, advance-practice registered nurses, pharmacists, laboratorians, radiology technicians, community volunteers, and administrative folks. For two days in August, many hundreds of uninsured or under-insured people had access to care from a dedicated team. We can do the same thing across our beautiful state.

What our state does not need is to allow advance-practice registered nurses and physician’s assistants to operate independently of physicians, as some are trying to move us toward. I support H.3508 because if enacted it would expand the scope of practice for the advance-practice registered nurses, compromising on several key points of contention, but maintaining the supervisory role of the physician.

Trustee, S.C. Medical Association

Lexington

This story was originally published April 19, 2015 at 11:00 PM with the headline "SC Medical Association’s Bullard: Teamwork is key to high-quality health care."