"It's the best way for them to practice to the full extent of their training. If my practitioner gets to a point where she's not confident in what she's dealing with, she has me to come to. I help educate her so she can take it from there."
Anyway, Phinney continues, "it's not like nurse practitioners are sitting around waiting to provide care. They're really very busy. This legislation wouldn't expand the work force. It just removes supervision."
As for optometrists, Phinney says, "some would know their limits. But opening the door to allow more [care] threatens patient safety."
And permitting pharmacists to alter prescriptions, he says, "could make someone's ailment a lot worse."
Hernandez' bills are scheduled for their first legislative hearing Monday.
The Brown administration is open to considering expansion of the non-docs' role in medical care.
"We haven't taken any position on the bills," says Diana Dooley, secretary of the state's Health and Human Services Agency, which is preparing for the startup of Obamacare.
"But we have to redesign the healthcare system. We need more managed care. We need to incentivize managing health instead of just treating disease. That underlies affordable healthcare," she says.
"To that end, there will be incentives for physicians to use more health professionals in their practices. There may be a need to consider the scope of services provided by other professionals."
How much might they expand?
"That's the conversation," Dooley replies. "We've got to be concerned about training and quality. And these bills are an opportunity to consider those issues. To the extent they give us more opportunity to manage health, they're worth considering."
One doctors' lobbyist, who didn't want to be identified because he was speaking off the reservation, told me: "Historically, the CMA hasn't wanted to give on anything. And the other groups want everything. Somewhere in the middle is where it's going to land.
"Everyone is trying to find the sweet spot — and flying the flag of ACA [Affordable Care Act] as the rationale for whatever they want to do."
We definitely should be using every medical professional's skills — while not sacrificing patient safety.
The Legislature and governor probably aren't expert enough to discover that fine line — the sweet spot. But they're the people empowered to do it. Hopefully they can negotiate an amiable truce to the turf war and make quality healthcare more accessible in inner cities and the boonies.