Independent providers and health-care homes could be the answer to rural hospital closures, writes H.E. James for the Daily Yonder. Independent providers have worked in James' home state of Idaho, where some counties don't have enough residents to support a hospital, while Minnesota has developed a model for health-care homes.
In independent provider clinics "primary care is given by physician assistants (PA) and even family nurse practitioners (FNP)," James writes. "PAs work under the supervision of a physician, but depending on the state issuing the license, an FNP may be free to run a practice fully independently. An increasing reliance on independent providers could actually improve care, and not because clinics can afford to hire more of them than doctors. Independent providers like PAs, FNPs, and LPNs more than likely have as much education as their medical-doctor counterparts. They are licensed to prescribe medicine and conduct certain clinical procedures." (Maryville University graphic)
"Of course, this model does not preclude medical doctors," she writes. "In Idaho, many of the rural clinics are staffed by an MD and a physician’s assistant or nurse practitioner, with the physician’s assistant or nurse taking the primary role.
It is a combination of these providers that will best serve a rural community. A permanent clinic need not even be in place. Like itinerant judges and preachers of old, some providers can establish weekly visits at community centers, schools, or clinics that were once shuttered but now open whenever care is needed."
The Minnesota Department of Health wrote a report in 2009 that attempted to provide a model for reforming rural health care by advocating the concept of health-care homes, James writes. "The health-care home isn’t a home in a traditional sense of the word. It’s a network of providers, from primary to specialty, on whom a community can call at any time to provide the necessary care. They are a great model for communities where patients with special needs, such as youngsters with a specific condition, live. Some health-care homes are simply networks. Others operate out of clinics." (Read more)
In independent provider clinics "primary care is given by physician assistants (PA) and even family nurse practitioners (FNP)," James writes. "PAs work under the supervision of a physician, but depending on the state issuing the license, an FNP may be free to run a practice fully independently. An increasing reliance on independent providers could actually improve care, and not because clinics can afford to hire more of them than doctors. Independent providers like PAs, FNPs, and LPNs more than likely have as much education as their medical-doctor counterparts. They are licensed to prescribe medicine and conduct certain clinical procedures." (Maryville University graphic)
The Minnesota Department of Health wrote a report in 2009 that attempted to provide a model for reforming rural health care by advocating the concept of health-care homes, James writes. "The health-care home isn’t a home in a traditional sense of the word. It’s a network of providers, from primary to specialty, on whom a community can call at any time to provide the necessary care. They are a great model for communities where patients with special needs, such as youngsters with a specific condition, live. Some health-care homes are simply networks. Others operate out of clinics." (Read more)
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