My Doctor Is Out
Posted 5/26/2017 by UHBlog
You wake up with a fever, sore throat, body rash and achy bones. The grandkids are coming to visit in a few days, so there’s no time to be sick. A call to your doctor’s office reveals he or she is out for the day, but the receptionist offers you an appointment with a certified nurse practitioner (CNP) or physician assistant (PA).
Should you take it?
Absolutely, says certified nurse practitioner Lynda Boldt, CNP, and you needn’t confine those visits to emergencies. Seeing a CNP or PA is a solid health care decision, not a consolation prize.
“Our role has expanded,” she says. “I can be a primary care provider, so, ‘When the doctor is out, why not see a nurse practitioner?’ is not a way of thinking anymore. We are all health care providers.”
Ohio House Bill 218, which went into effect April 4, redefines “health care professionals” to include physicians, psychologists, CNPs and other providers who examine, diagnose and treat medical concerns. With only a few exceptions, their services include prescribing medication.
The main difference between a CNP and a PA is that the training and licensing fall under different domains. Certified nurse practitioners are affiliated with nursing schools and nursing professional groups, while physician assistants are associated with medical schools and medical professional organizations. In Ohio, CNPs and PAs work with collaborative physicians, although many other states allow CNPs and PAs to operate independently.
“So there’s a different theoretical perspective, but we’re all geared to providing health care,” Boldt says. “You now need a doctorate for all nurse practitioner programs, and PAs are following suit.”
According to Boldt, CNPs and PAs can:
- Examine, diagnose and treat patients
- Perform some specialized exams, such as a colposcopy, which is a type of cervical exam
- Give immunizations
- Order lab work or radiology, and follow up on the results
- Oversee management of conditions such as high blood pressure and diabetes
- Prescribe some medications
“If I have a patient who needs a medication on my exclusionary list, I can go to my collaborative physician,” Boldt says.
Only a doctor can write prescriptions for drugs on the exclusionary list, Boldt explains. Before passage of House Bill 218, guidelines prohibited CNPs from prescribing certain drugs altogether, allowed them autonomy to prescribe some medications and required collaboration with a doctor for others. In some cases, CNPs could authorize a 72-hour refill on drugs initiated by a collaborating doctor.
“With respect to scheduled medications, the law is allowing for nurse practitioners in certain circumstances and settings the ability to prescribe medications in this category, the details of which are being processed now since the passing of House Bill 218,” Boldt says.
Whether you need to see a health care professional for an acute illness or injury, or you need someone to manage a chronic condition, it’s important to choose a provider with whom you are comfortable.
“We each have our own personality,” Boldt says. “At the end of the day, it doesn’t matter if we’re a CNP, PA or physician. We all want the patient to be comfortable and feel open enough to ask questions. We want to provide good care.”
Lynda Boldt, CNP, is a certified nurse practitioner in family medicine with Manuel Saridakis, DO; Michael Saridakis, DO; and Christopher Loyke, DO, at University Hospitals Parma Medical Center in Parma and University Hospitals Wellpointe Health Center in Broadview Heights. You can request an appointment with Lynda Boldt or any other health care professional online.