House Committee Passes HB 2266 8-4 – Public Health “Virtual Doctors”

OK-SAFE, Inc. - HB 2266, the Health Care Delivery Act, by Rep. Doug Cox, passed the House Public Health Committee on Tuesday by a vote of 8 Aye to 4 Nay.

An amendment by Rep. Mike Ritze was adopted, excluding certain provisions of existing OK statutes; this amendment left intact the main provisions of the bill, namely that registered nurses in public health settings (government nurses) can treat patients without a doctor’s involvement, utilizing instead “physician-approved protocols” and undefined “medial algorithms.”

HB 2266 Votes:

 YEAS:    8

    Cannaday     Enns              McDaniel, J.      Peters
    Cox          Holland           Nollan            Roberts, S.       

    NAYS:    4

    Derby       Grau              Ritze             Schwartz

In  essence, patients get cookie-cutter treatment, right or wrong, without the benefit of doctor supervision or interpretation.

Dr. Cox (R-HD5) did not mention, nor did any committee members ask, by which method would the physician-approved protocols and medical algorithms be utilized?  Via a software program? Or are they just printed out on a laminated cheat sheet posted on the wall of the facility?

Claiming no connection to “Obama Care” or knowing anything about  “virtual nurses or virtual doctors,” Cox went on to characterize his bill as just making legal what public health nurses have been doing for fifty years – acting without doctor supervision.

In essence what he’s proposing is to legally lower the standard for public health services in Oklahoma. Could we be getting a glimpse of what government controlled health care will really mean for all of us?

Protocols and Algorithms

According the bill, the public health nurses are to use “physician-approved protocols” and undefined, “medical algorithms.”

The bill says:  “Physician-approved protocols” means a protocol such as standing orders that describe the parameters of specified situations under which a registered nurse may act to deliver public health services for a client who is presenting with symptoms or needs addressed in the protocol.”

Standing orders describe how a nurse may act when certain symptoms are present.

Rep. Randy Grau asked Dr. Cox for the definition of medical algorithms, since this term was not defined in the bill.    Dr. Cox said they were “best practices.” Best practices evolve over time.

Actually, medical algorithms are defined as, “A medical algorithm is any computation, formula, statistical survey, nomogram, or look-up table, useful in healthcare. Medical algorithms include decision tree approaches to healthcare treatment (i.e., if symptoms A, B, and C are evident, then use treatment X) and also less clear-cut tools aimed at reducing or defining uncertainty. be a multitude of things, including computations, formulas, and if/then decision trees, i.e. “If A, B, and C are present, do X.”

Who needs a doctor if all you have to do to properly diagnose patients is an if/then decision tree?  Like we said in our earlier post on this bill – this is a move toward virtual doctors.

Instead of doing what a real conservative would do – limit the size and scope of the costly public health system to the point where they could actually operate with both doctors and nurses, and access to a pharmacist – this big-government Republican wants to just allow nurses to act as doctors and thinks access to magical protocols and algorithms can replace real doctors.


Government nurse: “Stand still. The medical algorithm indicates this is the right dose for a carbon-based unit of your height and weight.”