By NYSSOS President Samuel Flemister, MD
(Based on Written Testimony Submitted Earlier Today)
Governor Hochul ’s 2023-2024 Executive Budget proposal contains a number of elements that are of particular interest to orthopaedic care providers as they relate to our ability to sustain access to the best possible patient care.
We are grateful to see the proposed extension of the excess medical malpractice program through June of 2024. This program is essential to New York ’s ability to maintain a workforce of physicians that can meet current and future service demands. We would ask the Governor and Legislature to extend this program for more than just one year, however, since many physicians base their practice location decisions on multi-year environmental forecasts, including medical malpractice costs, which are already the highest in the nation in New York.
Additionally, NYSSOS supports the investments made by the Executive to aid in the recruitment and retention of skilled medical staff. We are indeed facing a staffing crisis that demands urgent government action, and we prevail upon the Legislature to make any additions possible to these efforts.
NYSSOS is also supportive of the Governor’s proposals to promote the avoidance of tobacco products. Tobacco has been shown to have detrimental musculoskeletal effects, both directly through smoking and passively through secondhand smoke inhalation.
There are other provisions in the Governor ’s proposal, however, that are of great concern relative to their likely impact on the quality and availability of care.
Chief among these concerns are plans to eliminate physician supervision requirements for Physician Assistants with 8,000 or more “primary care” practice hours. This action will significantly diminish the quality, safety and reliability associated physician-led care, especially for vulnerable populations. The promise of more effective and cost-efficient care rests not on the idea of physician extender independence, but rather on better practice integration of these skilled providers under the existing supervisory structures that are paramount to both care quality and patient safety. We therefore urge the Legislature to reject this proposal and to prioritize building healthcare teams with appropriate safeguards and increased transparency.
Similarly, NYSSOS is concerned with the potential unintended consequences of the Governor’s proposal regarding ‘Site of Service Reviews.’ This is a complicated proposal that deserves further study and scrutiny before any changes are enacted. NYSSOS believes the timeline for enacting the state budget stifles the opportunity for deliberative discussions and this proposal should be considered outside of the budget process.
Lastly, the Governor ’s proposal to submit certain private practice matters to state review and approval may pose a considerable threat to the organic evolution of medical services, especially in communities where the need for care is most acute. Minimally, we would ask the Legislature to remove this policy matter from the omnibus budget legislation and carefully consider its implications as a stand alone proposal. Within any context however, as written, we would urge the Legislature to reject it.
About NYSSOS: Representing more than 800 orthopaedists across New York State, NYSSOS advocates for orthopaedic surgeons, patients and musculoskeletal health in New York State. NYSSOS is the orthopaedic community’s primary source of information and expertise concerning: legislative/regulatory advocacy (local, state and federal levels); practice trends and change; leadership training for national, state, and local issues and opportunities; assistance with establishing and maintaining a practice; and familiarity with state practice guidelines impacting the profession and patient care. Learn more at www.nyssos.org