Dear Mr. President...

March 21, 2009

As a Nurse Practitioner, if I think I should order a lab test on a client, then I should be able to order it. I went to school, I’m a seasoned clinician. But sometimes I can’t order or provide diagnostics, even if my clinical judgment and training provides solid rational for why. Huh? Well here it is, I have worked at several hospitals, and guess what, they all put the heat on you if you are ordering too many things for patients, or if you are ordering “non-essential” tests. Are you surprised? So all of us trying to help you, all the doctors, nurse practitioners, physician assistants, we are being reprimanded on a daily basis for driving the cost of health care up because of things we order for you. And as for “universal health care,” it’s been here for years already! Medicare, Medicaid, and private insurance companies have always been dictating to the health care providers what we can and can’t do for you. Sometimes I need to admit a patient, but the insurance company says no. You all need to know we fight on the phone for hours to get you what you need and deserve. You wonder why you are sitting in the ER waiting so long to be admitted for psychiatric services…it’s because we are in the back office arguing with the insurance company to approve the admission. So Dear Mr. President, here is the answer to the health care crisis…give the clinical control back to the health care providers. Let me order what I know my patient needs. Let me take care of my patient the way I feel is right, and compensate me for that service in a fair, equitable manner. Sure we will need “watchdogs” and some distant level of oversight, but don’t tell me I can’t order a B12 level on my depressed patient……..just don’t.