Becker's Hospital Review

44 CMO / CARE DELIVERY Care concerns emerge from Missouri's 'assistant physician' licensure program By Megan Knowles A er the Missouri legislature created a category of physician licensure to curb primary care phy- sician shortages in rural areas, researchers are concerned these assistant physicians' low first-time pass rates on licensing exams could lead to worse clinical out- comes, JAMA reported. e assistant physician must be a citizen or legal resident of the U.S., a graduate of a recognized medical school, profi- cient in English, passed steps one and two of the U.S. medical licensing examination and not have finished a residency. Assistant physicians are limited to providing primary care ser- vices in underserved areas and can only practice under col- laborative practice agreements with fully licensed physicians. ey have a scope of practice and responsibilities consistent with physician assistants and advanced practice nurses. To assess the qualifications of assistant physicians and the care quality they provide, the researchers looked at data on all assistant physician licensees from Jan. 1, 2017, through Dec. 31, 2017, from the Missouri Board of Healing Arts. e researchers raised concerns about assistant physician licensure based on assistant physicians' first year of expe- rience in Missouri. e study found assistant physicians were considerably less likely to pass steps one and two of the medical licens- ing examination on the first attempt than all graduates of U.S. medical schools from 2012-16. Failure of step two is linked to increased disciplinary action and worse clinical outcomes, the researchers said. Only 25 percent of the licensees secured collaborative agreements during the first year, meaning they were the only ones who could practice. Additionally, despite re- quirements that the collaborative practice be in under- served areas, 20 percent were not in areas facing a primary care shortage. e study is limited by a lack of data on licensees, prac- tice settings and employers as well as the fact that data was available only for one year, the researchers said. "Future research should study the quality and safety of the care that assistant physicians provide and their clinical roles and career path, as well as patient perceptions," the re- searchers wrote. "e Missouri legislature recently broad- ened the licensure beginning in 2019; however, it is unclear what effect these changes will have." n 10 highest-paying nursing jobs By Megan Knowles N urse anesthetists had the highest average salary in 2018 out of 27 nursing job titles, earning about $150,900 on average, according to a survey con- ducted by Advance Health- care Network. The survey includes responses from more than 22,000 nurs- es at every level and focused on specialization, location, education and benefits. Sixty respondents said they were nurse anesthetists. Of the 13,038 respondents who offered a specific job title, about half said they were staff nurses. The average salary was $73,287 for these professionals. Here are the 10 job titles with the highest average salary, ac- cording to the survey: 1. Nurse anesthetist: $150,833 2. Midwife: $115,000 3. Nurse practitioner: $114,901 4. Nursing administrator/di- rector/manager (not regis- tered nurses): $109,947 5. Nurse midwife: $108,824 6. Administrator/director/ manager (registered nurses): $101,717 7. Nurse consultant: $99,115 8. Nursing informaticist: $98,182 9. Clinical administrator: $89,474 10. Clinical nurse specialist: $88,271 n Essentia Health introduces systemwide 30-minute flu, strep testing By Harrison Cook D uluth, Minn.-based Essentia Health launched a large-scale rapid result testing system for influenza A, B, strep throat and respiratory syncytial virus. The health system invested about $2 million to acquire 60 Ce- pheid analyzers for its hospitals and clinics. Essentia is the first system in the nation to implement the whole line of testing sys- tems from the molecular diagnostics company. While this tech- nology has been available to hospitals for years, the FDA waived testing regulations to allow outpatient facilities to use the ad- vanced diagnostic systems this year. "The Cepheid analyzers are molecular-based systems that detect the DNA or RNA of infectious bacteria or viruses in patient sam- ples," David Carter, MD, a pathologist at Essentia Health, said in a press release. Essentia clinicians will use the new analyzers in outpatient facili- ties, which most insurance companies will cover, starting in No- vember. The system will allow patients at Essentia Health clinics to receive test results within 30 minutes. In 2017, Essentia performed about 40,000 strep tests on patients across Minnesota, Wisconsin, North Dakota and Idaho. n

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