Strengthening the Healthcare Workforce and Protecting the Medical Profession: A Comprehensive Approach

Strengthening the Healthcare Workforce and Protecting the Medical Profession: A Comprehensive Approach

The healthcare industry is facing numerous challenges, including a shortage of doctors, nurses, psychologists, and other essential healthcare professionals. This scarcity of skilled professionals has prompted the U.S. Department of Health and Human Services (HHS) to invest $100 million in expanding the nursing pipeline. However, addressing this issue requires a multifaceted approach that goes beyond simply increasing the number of professionals in the field.

HHS Secretary Xavier Becerra acknowledges the pressing need for more healthcare providers, stating, "We don't have enough doctors or nurses practicing. We don't have enough psychologists or counselors to address the rising rates of substance use disorders. We don't have enough midwives, pharmacists, and professional caregivers to meet the needs of Americans. We need more." This shortage not only affects patient care but also places a significant burden on existing healthcare professionals.

One of the major challenges faced by nurses is the lack of support from Certified Nursing Assistants (CNAs). Without sufficient CNAs, Registered Nurses (RNs) are forced to take on additional responsibilities, leading to increased workloads and burnout. To alleviate this issue, it is crucial to focus on building a pipeline of CNAs who can provide support to the current and future RN workforce. By ensuring adequate support staff, RNs can focus on their core responsibilities and provide better care to patients.

The corporate practice of medicine (CPOM) doctrine is another area that requires attention. The CPOM doctrine was established to prevent unlicensed lay entities from owning or controlling medical practices. However, the recent surge in corporate investments in healthcare has raised concerns about the erosion of this doctrine. Today, more than half of all physician practices are owned by hospitals or corporate entities.

The rise of highly leveraged and multilayered deal structures has given corporate investors greater market power and insulation from risk. These entities have started assuming control over clinical operations, management decisions, billing practices, and negotiations with insurers. This shift of power can lead to changes in care delivery, reductions in staffing, and increased pressure on physicians to prioritize revenue generation over patient care.

To protect the medical profession and the public interest, it is vital to strengthen the CPOM doctrine. One way to achieve this is by closing existing loopholes that permit corporate ownership. For example, some states allow limited-liability companies and partnerships to deliver medical services without being subject to physician-ownership requirements. By eliminating these loopholes, the ultimate control of medical practices can be retained by licensed professionals.

Additionally, management-services agreements (MSAs) have been used to circumvent CPOM restrictions. These agreements allow corporate entities to exert control over physician practices while maintaining a semblance of compliance. To address this issue, tighter regulations should be implemented, ensuring that MSAs do not undermine the intent of the CPOM doctrine.

In conclusion, addressing the healthcare workforce shortage and protecting the medical profession requires a comprehensive approach. Increasing funding for nursing programs is a step in the right direction, but it should be accompanied by efforts to build a pipeline of CNAs to support the RN workforce. Strengthening the CPOM doctrine is also crucial to prevent corporate entities from exerting undue influence over medical practices. By closing existing loopholes and regulating management-services agreements, the integrity of the medical profession can be preserved, and patient care can be prioritized.

Actionable Advice:

• 1. Increase investment in nursing programs and support the development of CNAs to alleviate the burden on RNs and improve patient care.

• 2. Advocate for the closure of existing loopholes that allow corporate ownership of medical practices, ensuring ultimate control remains with licensed professionals.

• 3. Implement stricter regulations on management-services agreements to prevent corporate entities from exerting undue control over physician practices, prioritizing patient care over revenue generation.

By adopting these actionable steps, we can work towards a stronger healthcare workforce and protect the integrity of the medical profession, ultimately improving patient outcomes and healthcare delivery.