Tuesday, December 9, 2008

A Question of Inclusion or Exclusion: State Licensing and the AmSect Government Relations Committee (GRC) Position

There continues to be a major problem with AmSect’s desire for state mandated professional licensure of all perfusionists. I'd like to call attention to the fact that there is, at present, no workable, fair or real reciprocity between states in the licensing of Perfusionists, even though the GRC claims this to be fact. In the event of a medical emergency, this is a serious situation.

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To illuminate the problem, here is a case in point: I received a telephone call one Friday afternoon that an ECMO Team was immediately needed in Texas to monitor a baby girl. All my Texas travelers were on assignment and unable to fill the need. In response, however, I inquired at the Texas state's licensing office about any provision in the law for quick licensing for emergencies. My Perfusion staff licensed from other parts of the country could be credentialed, but unfortunately state licensing for an emergent situation in Texas had no provisions, or so I was told. NOTE: The same response was given in MO, TN, and GA when we experienced similar situations in past years.

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Several state licensing offices charge upwards of $400 to $700 per license annually and yet they are clueless about what a Perfusionist is or does, nor do they seem to care. That is, if you can locate them.

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In the case of the Texas ECMO baby, patient care suffered and unfortunately there was a negative outcome. I wish I could report that this was a one-time occurrence, but we have experienced similar events a multitude of times over the years as we tried to be of assistance to hospitals and perfusion colleagues who reached out to us. We appealed to the Government Relations Committee through a friend and an associate who was a member and who presented the case in 2007.

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The issue has been a point of contention for years for many perfusionist who are sole proprietors and for contract companies like Trident, which provide locum tenens services on a national scale.

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When individual states put their regulations together, supported and directed by AmSect, I wonder: Were they thinking more of exclusion than inclusion? Less about patient-focused care or rights of patients? Is the public welfare served by this endeavor? There are many good reasons to have licensure, but to me, it just doesn’t seem that the support from AmSect has been thought out to include all services, especially emergent care that is readily available from providers like Trident.

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We approached AmSect about the problem and the response, in my opinion, was idealistic, lacking expansive thought and bordering on irresponsible . That reply is posted here:

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CLICK HERE for AmSect’s Response

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I don't want to make this issue about contract companies such as Trident versus hospital-based or instate perfusion groups, but this protect your turf mentality is not only short-sighted and paranoid, but goes against the precepts of inclusion. I would be interested to hear reader thoughts and any experiences you've had as a contractor or other perfusion providers concerning this topic.

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This problem is not isolated or regional. It is nationwide. My question is, Where is the leadership? Or, is this the harbinger for new thought for establishing another (more enlightened) organization that will truly support what perfusion and care of the patient is all about?

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Inclusion or Exclusion? What's your take on this? Oh, by the way, and for the record... We haven’t even touched upon the concept of free enterprise or the restriction of trade or how the public good is served by this endeavor.

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Please post comments here or email me directly.

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RALPH E. JORDAN

CEO & President

1 comment:

Anonymous said...

State Licensure has been extremely short sighted. In the beginning, it allowed exclusive privileges to the few who chose to work in single States. Presently, it has become a handicap in providing perfusion services in areas or situations of extreme need. Instead of ensuring quality care, it has inserted a road block when all that was needed was greater vigilence. States seeking licensure need to heed the lessons learned from those who have already gained such.