American College of Physicians: Internal Medicine — Doctors for Adults ®


Regents discuss mid-level providers, Oregon health plan and GME

From the March 2000 ACP–ASIM Observer, copyright © 2000 by the American College of Physicians–American Society of Internal Medicine.

At its January meeting, the Board of Regents approved positions on issues ranging from mid-level providers to Oregon's health plan.

The Board acted on the following issues:

  • Mid-level providers. The Regents approved an updated version of the College's 1994 position paper that supports collaborative roles for nurse practitioners and physician assistants within a system of physician responsibility for quality of care. The paper, however, opposes the independent practice of nurse practitioners and direct payments to them. In the updated paper, which will appear on ACP­ASIM Online (, the College continues to support efforts to collect clinical outcomes and cost data for mid-level provider treatments.
  • Oregon health care. The Board approved a paper that examined the Oregon health plan and considered whether it is a suitable model that other states can use to increase health care access. While the paper notes that Oregon's plan has fostered discussion about access, it concludes that the program could not be readily adopted by other states because of a number of factors unique to Oregon. The position paper will appear on ACP­ASIM Online.
  • GME. The Regents endorsed a paper, "Why Medicare Funds Graduate Medical Education." The publication, which was developed by a task force of the newly formed Alliance for Academic Internal Medicine, outlines the reasons that Medicare should continue to fund graduate medical education. The paper has been submitted for publication.

In other business, the Regents voted not to recommend the establishment of a political action committee. (See "Regents say no to PAC" from the February ACP­ASIM Observer on ACP­ASIM Online.) They also approved a preliminary response to the Institute of Medicine (IOM) report on medical errors. In its response, the College agreed with the IOM that a national center to improve patient safety should be established. But it expressed concern over the IOM's call for mandatory reporting of medical errors, supporting instead a system of voluntary reporting that would protect the confidentiality of data. (See " A look at the College's response to the IOM report on medical errors.")

The Regents also approved a report from the Medical Services Committee on Medicare physician payment issues. (See "How the College is working to resolve differences with subspecialists.")

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