Traditional Power Structure In American Medicine

The traditional power structure in American Medicine is based on skill, knowledge and expertise. At the top of the pyramid, is the ‘wise, all-knowing’ physician. He or she has attended college or university for many years, and is the leader and decision-maker of the medical professional team. Below the doctor is the physician assistant. They are not qualified to perform surgery on their own, but may do so under the guidance of a physician. “Physicians assistants may be able to resolve the significant issue of providing more primary-care practitioners in the American system of healthcare delivery” (305). Under physical assistants are nurses, who historically are less well-educated than their physician co-workers, although that is starting to change. Some nurses are on the same level of physicians assistants. It should also be said that the supportive role that nurses play for physicians is less distinct when they are partnering with physician assistants, who lack the prestige and authority that a physician possesses. This traditional power structure is changing in modern times. The
Instead, there is an influx of nurses with master’s and even doctoral degrees. There is also a shortage of physicians in the US, which has prompted an increasing reliance upon PAs, and highly-qualified senior nurses. This includes the clinical nurse leader and the nurse practitioner. The nurse practitioner can diagnose and treating patients on her own (Rankin, 2015). In terms of the impact of clinical nurse leaders, studies show that units with a CNL have greatly reduced hospital infection rates, and that physicians report much higher satisfaction when a CNL is in their unit (Rankin, 2015). Highly educated nurses can take the pressure off of physicians in many cases, by providing leadership and patient treatment