C. Treatment

• Library: A Practical Guide to Elder and Special Needs Law in South Carolina (SCBar) (2021 Ed.)

C. TREATMENT

1. Different Types of Primary Care Providers (PCPs)

Across the United States, Primary Care Providers (PCPs) is a term the medical community has embraced and widely adopted. The demand for basic health care has increased, hospitals have begun to identify delivery and access barriers by expanding the types of medical professionals capable of providing primary care to patients. This expansion has aided hospitals in adapting to the rapidly changing health care landscape and improving patient access to basic health services. PCPs are not limited to the traditional Medical Doctors (M.D.s) but include Doctors of Osteopathy (D.O.s), Nurse Practitioners (N.P.s), and Physician's Assistants (P. A.s).

a. Doctors of Osteopathy

Both Medical Doctors (M.D.s) and Doctors of Osteopathy (D.O.s). are physicians licensed to practice medicine. A "physician" is defined to be a person "licensed by the South Carolina Board of Medical Examiners who possesses an active, unrestricted, permanent license to practice medicine in this State and who actively is practicing within the geographic boundaries of this State." S.C. Code Ann. § 40-33-20. The four-year medical or osteopathic school differs slightly, however, both require continued education through residencies or internships. Additionally, both M.D.s and D.O.s must pass similar standardized exams with the South Carolina Board of Medical Examiners to obtain licensure and board certification. Overall, the main difference between M.D.s and D.O.s, is that D.O.s focus on a "whole body" approach to medicine that emphasizes prevention, environment and lifestyle, and nutrition. S.C. Code Ann. § 40-47-20. Rather, M.D.s focus on a symptom focused assessment, diagnosis, and treatment of disease.

The American Osteopathic Association calculated that there are 114,425 D.O.s in the U.S. and 30,918 osteopathic medical students as of 2018. As one of the fastest growing health care professions in the country, there has been a 54% increase of D.O.s since 2010. 57% of those D.O.s are trained and practicing in primary care. American Osteopathic Association, Osteopathic Medical Profession Report 2018 (2018), https://osteopathic.org/wp-content/uploads/2018-OMP-Report.pdf.

S.C. Code Ann. § 40-47-25 provides:

"Osteopathic physicians and surgeons licensed hereunder shall have the same rights and privileges as physicians and surgeons of other schools of medicine with respect to the treatment of cases, hospital privileges, and the holding of health offices or offices of public institutions. Physicians and surgeons licensed pursuant to this chapter must be licensed to practice medicine in all its branches regardless of whether the physician holds an M.D. or D.O. degree and has passed the United States Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX - USA) examination sequence, or graduated from a college accredited by the Liaison Committee on Medical Education (LCME) or the American Osteopathic Association (AOA), Commission on Osteopathic College Accreditation (COCA), or successfully completed post-graduate training from the American Council for Graduate Medical Education (ACGME) approved or AOA-approved programs, or obtained American Board of Medical Specialties (ABMS) or AOA board certification, or on the basis of his or her race, color, creed, religion, sex, or national origin."

b. Nurse Practitioners

The most recent additions to traditional PCPs include Nurse Practitioners, NPs, and Physician's Assistants, PAs. The Nurse Practice Act defines a nurse practitioner as "a registered nurse who has completed an advanced formal education program at the master's level or doctoral level acceptable to the board, and who demonstrates advanced knowledge and skill in assessment and management of physical and psychosocial health, illness status of persons, families, and groups." S.C. Code Ann. § 40-33-20. Practical nursing includes, but is not limited to, collecting health care data to assist in planning care of persons; administering medications and treatments; implementing nursing interventions; and teaching health promotion and maintenance concepts. S.C. Code Ann...