Here at the humble blogger institute, we are constantly at the forefront of new ideas which, if implemented, will be very successful.  Assuming, of course, that success is measured in the goodness of intentions, and not in any sort of results.

Right now, the panel QME system, to borrow language from the youngins, “sucks.”  It takes six months to get a panel, the Medical Unit will use any possible excuse to kick your panel request to the curb (letting the wrong done you by the treating physician stand for yet another six months), and the pickings on the panel itself can be slim depending on where you are – pretty soon, you’re dealing with the same faces over and over again.

So, if we’re not willing to put more cheese in the workers’ comp mouse trap by paying QMEs more (and attracting new physicians to the game) perhaps we need to embrace the growing trend in the general medical community: let’s open the door to nurse practitioners.

In some states, nurse practitioners can prescribe medication, open their own practices, and generally treat and refer patients to care.  How hard will it be for a nurse practitioner to take measures as directed in the AMA Guides and apply them to generate an AMA compliant report?  Seriously, folks, we have attorneys and adjusters that are practically experts at AMA Guides and Almaraz/Guzman – a nurse practitioner should be even more capable than us, or at the very least, capable enough.

Also, Nurse Practitioners graduate with significantly less debt, and so can take jobs that don’t pay as much while still paying their bills.  So, while a doctor who is 5 years out of 30 in paying off student loans might think that his or her time is better spent seeking more lucrative engagements, a nurse practitioner can afford to take on the QME jobs for the QME paycheck because of the lower overhead.

Currently, Labor Code section 139.2(b) allows appointments “if the physician is a medical doctor, doctor of osteopathy, doctor of chiropractic, or a psychologist” but not a nurse practitioner.

Now, your humble blogger understands that some people have reservations about nurse practitioners.  Doctors have long held a very esteemed and respected position in our society.  Some might be hesitant to deviate from this cultural authority.  Others, particularly in the defense community, might be concerned that nurse practitioners would erroneously rely on subjective complaints without verifying the objective signs of impairment necessary for many ratings.

That being said, your humble blogger suggests that this can be remedied with proper training and screening.

So, what do you think, dear readers?  Is it time that the world of Workers Compensation joined in the dawn of the Nurse Practitioner?