By Surabhi Dangi-Garimella, Ph.D.
Standing orders help the physician share the responsibility of patient care with non-physician members of their care team, such as nurses and medical assistants. These are clinical care protocols based on national clinical guidelines that may be customized based on the patients that a practice serves. Standing orders have to be approved by the clinical leadership and the staff has to undergo training to implement standing orders.
How Do Standing Orders Help Physicians?
Primary care practices can hugely benefit from standing orders. Standing orders would bring a big relief for physicians who are already stretched on time. By issuing standing orders, physicians can focus their attention on taking care of patients’ acute care needs while delegating routine patients to designated team members such as nurses or medical assistants. The designated nurse or assistant can then follow protocols to conduct a routine clinical task without the need for a physician order, such as vaccination. The effectiveness of this process, in fact, led the Task Force on Community Preventive Services—which was established to identify interventions at the population level that will save lives and improve quality of life and survival—to recommend a standing order for non-physician medical staff to deliver or prescribe vaccinations to adults without the involvement of physicians.
An example of a standing order for the recent Moderna COVID-19 vaccine, developed by the Centers for Disease Control, can be found here.
Improved Patient Care
Standing orders can save lives! Consider the tactic used by states for the prescription anti-overdose drug naloxone—a standing order allows opioid addicts or those who care for them, to have quick access to naloxone without having to visit the doctor’s office. The public health commissioner or chief medical office of the state, or even a licensed pharmacist (if the public health official is not a licensed physician), can fill in the place of a prescribing physician.
Similarly, hormonal contraceptives require a doctor’s prescription and are not available over the counter. To circumvent this, 11 states and Washington, D.C., authorize pharmacists to provide contraceptives without a prescription via several means, including standing orders. This allows safe and timely access to contraceptives.
What’s important to note is that an individual or patient can still seek their physician’s advice if they are not comfortable with the nurse’s or pharmacist’s recommendations.
Surabhi Dangi-Garimella, Ph.D. is a biologist with academic research experience, who brings her skills and knowledge to the health care communications world. She provides writing and strategic support to non-profit groups via her consultancy, SDG AdvoHealth, LLC.