FP Report -- December 1998 Proposed rule would hinder rural care
People living in rural areas of the country may find it harder to get medical care if the Bureau of Primary Health Care proceeds with its proposal to redesignate health professional shortage areas and medically underserved populations. The AAFP opposed the proposal in a Nov. 2 letter to the bureau from Board Chair Neil Brooks, M.D., of Rockville, Conn.
The letter spelled out the AAFP's opposition to several aspects of the proposal, including the plan to make the ratio of population-to-primary-care-provider only one of many factors in designating a HPSA. Other factors, such as rates of poverty, low birthweight, minority status and linguistic isolation, would also be considered.
"The Bureau of Primary Health Care anticipates that 300 counties, and about 8 million people, would lose their HPSA or their existing MUA (medically underserved areas) status," Brooks wrote.
The proposed regulation also would count nurse practitioners and physicians' assistants as "half" physicians in calculating the population-to-primary-care-provider ratio. "While the Academy views mid-level providers as a valuable component of a cooperative practice arrangement, we recommend that the final regulation count mid-level providers only if they are confirmed to be practicing in a collaborative primary care setting under the direct supervision of a practicing, licensed primary care physician," Brooks wrote.
FP Report is published by the AAFP News Department. Copyright © 1998 by American Academy of Family Physicians.