How to ditch doctors in 90 days

Medicine today appears to be reduced to merely writing prescriptions, with diagnoses, complementary treatments, psychological care and addressing the root causes of health issues and fixing them being sidelined.This gives rise to the optimistic notion that even more providers may soon be authorized to prescribe medications without needing to leave their chairs—or perhaps even fully understand what they are treating. This may seem more acceptable as long as the so-called “doctors,” often perceived as greedy and arrogant, are kept out of the equation, and the associated funds do not flow to them, as they are often blamed for being the root cause of systemic issues. Indeed, in many cases, if you want to identify the source of a problem in any sector, it’s not uncommon to point the finger at doctors.Moreover, what further simplifies the process of expanding the pool of prescribers is that proper diagnosis has become less of a priority. For example, treating a virus with antibiotics, misdiagnosing a bladder tumour as a urinary tract infection or mistaking an anal abscess for hemorrhoids are no longer seen as significant errors. Such actions rarely seem to have consequences for non-doctor prescribers. In contrast, if a doctor were to make similar mistakes, they would face severe repercussions, including the possibility of suspension, even though their role appears increasingly redundant as replacements are readily available. So really by finding more prescribers and replacing doctors, we are actually protecting doctors from penalties and suspensions! Read: Dr. Jabir Jassam: Physicians and social isolationProposal for expanding scopeWith my tongue firmly stuck in cheek, in an effort to further reduce reliance on doctors and their involvement in the system thus minimizing troubles for them and less complaints, I suggest it is possible to expand the following scopes:Midwives: “Midwives can be authorized to manage any condition below the umbilicus, including urinary tract infections, vaginitis, vaginal discharge, antenatal and postpartum care and general gynecological conditions, such as conducting Pap smears and managing pregnancy-related issues. Their scope can also extend to more conditions like appendicitis or diverticulitis, with the ability to refer complex cases to nurse practitioners if necessary.“If some ambitious midwives would like to be involved above the umbilicus. They can take an extra one month of training.”Chiropractors and physiotherapists: “Chiropractors and physiotherapists can manage all musculoskeletal injuries or pain. Additionally, chiropractors may expand their scope to include managing conditions like autism, ADHD and concussions.“Although both chiropractors and physiotherapists have wide knowledge, they could get more training to read imaging, such as X-rays, CT scans and MRIs, enhancing their diagnostic capabilities, moreover they could get three months training for joint replacement (all joints) and other orthopaedic surgeries. “I do not believe it would be difficult for chiropractors to also do brain surgeries if they get an extra three months of training.“To avoid conflicts between chiropractors and physiotherapists, a regulatory body should oversee their practices to ensure collaboration and avoid any disputes that could negatively impact patients.”Nurse practitioners: “Nurse practitioners can be authorized to see all kind of cases above and below the umbilicus and interpret advanced imaging studies, including CT, PET scans and MRIs, reducing the need for radiologists. They may also be trained to perform procedures such as colonoscopies and endoscopies, abdominal surgeries to further minimize the need for gastroenterologists and surgeons including ENT and skin procedures. As well, they could do heart issues to ditch more cardiologists—they will soon start to put pacemakers in and maybe valve replacement. If any nurse practitioner wants to be an anesthesiologist, a one-week training should be offered.” Optometrists: “Optometrists can be enrolled in a three-month intensive training program to perform eye surgeries, significantly reducing the need for ophthalmologists. This training should include administering anesthesia as well.” Pharmacists: “Pharmacists can undergo a one-month training program to perform minor surgeries, Pap tests and diabetes management and offer extra month training if they like to do ECT or cardioversion but there is a possibility that they can perform these procedures without trainingPsychotherapists and psychologists: “Psychotherapists and psychologists can be authorized to prescribe medications for depression, anxiety, antipsychotics, ADHD, etc. This expanded scope would reduce reliance on family physicians and psychiatrists for mental healthcare.”Registered and practical nurses: “For cases that none of the above providers can manage, registered and practical nurses can be enrolled in a three-month training program to acquire advanced skills, including performing major surgeries. This would ensure comprehensive patient care without requiring a physician's involvement.”OutcomesThis outlandish proposal minimizes the need for doctors, allowing patients to be seen more quickly. While this approach prioritizes access over diagnostic precision or treating root causes, it would seem to align with the current trends in healthcare delivery.Other workers’ scopes will be added when the needs arise. If we do that, we certainly can ditch all doctors in 90 days.Dr. Jabir Jassam is a family physician in Ottawa.

How to ditch doctors in 90 days

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