Question

You are a busy neurologist (1 of 3 neurologists) working in your private practice. There just seems not to be enough hours in the day for the amount of work that needs to be completed. Your work involves seeing patients daily in the practice, which includes doing small procedures like lumbar punctures or botulinum toxin injections for various purposes. You and your partners are burning out and you all agree that a solution is needed. Your practice accountant advises you all that there is enough money in the budget to hire another neurologist or 2 physician extenders (either PA or nurse practitioners) but not both. Using this scenario, explain to me what you would do next. Would you hire another neurologist to the practice or would you hire 2 physician extenders? Defend your decision. Spell out the Pros and Cons of each choice.

discuss both the positive and negative or unintended consequences of shared decision making in patient care and its impact on healthcare quality (good or bad) and its impact on healthcare economics (good or bad). you can cite personal experiences and the scenario above with regards to shared decision-making (either as patient or healthcare provider)

Answer 1

Pros of having a Physician Extenders:- -Hand on help will be more. A side by support can make the work more faster to do.

-Less spending.

-Space can be compromised as a PA may not need a full working chamber to do his/her job.

Cons of having a PA:- -PA can't replace the work of a neurologist. They can just assist them.

-Not much help in quick decision making.

Pros of having Neurologist:- -Quick decision.

-Less number of patient crowd will be there for each doctor.

-Can assist another doctor in emergency situations.

Cons of having Neurologist:- -the main problem is huge salary of a neurologist.

-another full setup has to be ready and the cost behind it.

Impact on patient health due to a neurologist :- For the extra charge, the hospital or clinic may charge it out from the patients. But better care can be expected as number of neurologists are more.

Impact on health care quality:-It will be better on hiring a neurologist.

Impact on patient health due to PA:- More care will be there, but lack or same diagnostic decision making will be there as earlier. Patient health care may improve due to extra assistance from a PA.

Impact on health care economics:- Cost charges will increase in both cases but more in the case of neurologist.

If I had to choose, I would rather go for a neurologist if it is in the budget. Or else, PA is a good option.