A Nurse Practitioner's View

USA Today reports on a newly proposed drug labeling system that will attempt to enhance information about the effects of medicines used during pregnancy and breast-feeding. The following is from the FDA's press release : "With this proposal, FDA's goal is to help women, their physicians and their pharmacists have better information about the effects of prescription medicines so that pregnant women, nursing mothers, and breast-feeding infants will benefit," said Rear Admiral Sandra Kweder , M.D., Center for Drug Evaluation and Research, FDA. "This proposal would help make drug labeling a better communication tool, and would potentially have a huge impact on public health and well being for women." The proposal would eliminate the current pregnancy categories A, B, C, D, and X and replace them with a consistent format for providing information about the risks and benefits of medicine use during pregnancy and lactation. The USA Today article goes on to say th...

There have been 2 recent articles (one in a Boston publication and one in an upstate New York publication) about the concept of the medical home. This term is thrown around an awful lot these days and means much more than just a solo or group of primary care providers. This is a patient-centered approach to care that uses a coordinated effort by a team of health care professionals focusing on preventative health services right through hospitalizations. You can see the wikipedia definition of medical home here . Professional organizations such as the AAFP , AAP , & ACP (among others) have even adopted formal policy statements on this. One of the main reasons that this concept hasn't gone anywhere is because the coordination of this type of care (the phone call consults, e-mails, paperwork, etc) hasn't traditional been reimbursed by insurance companies. These new pilot projects are attempting to remedy that. Also encouraging is that NPs are being utilized in this model and...

Here is a comprehensive article written in the Physician's News Digest entitled, " Growing role of nurse practitioners ." This balanced article gives a synopsis of the current state of the profession and where we might be headed. Also written this past week was an article about nurse practitioner-staffed retail clinics in Atlanta.

Here is a great little post about the use and overuse of antibiotics from an ER physician blog, entitled, " We are so screwed ." We all know that it is easier to write a script for someone demanding antibiotics rather than explain the risks, benefits and commitment of taking antibiotics. It is so important to not give in. I'll never forget the patient that I saw with a 1-2 day history of nasal congestion and very mild symptoms. I went into my whole routine of explaining why I felt her condition was viral and antibiotics weren't necessary. After that whole little dialogue, I asked her if she had any questions and she says, "Uhh, can't I just get a Z-Pak?" What??? Were you even listening for the past 3 minutes??? (FYI, I did not write for the Z-Pak.) I'll never understand the rationale of wanting to take a medication that isn't clearly indicated, can cause gastrointestinal issues, can be expensive and is usually a commitment for 10 days (that's...

Once again, an article about retail health appears on the WSJ Health Blog site and the discussion ends up being about NPs versus MDs . Under that thread, a whole firestorm is set off when someone by the alias of "real doctor" claims that patients have returned to his office following visits to the retail clinics because they "were not treated appropriately." I certainly felt the need to respond to this arrogant attack on NPs and did so as "Real Nurse Practitioner." So what follows is the typical rhetoric from purported physicians and includes: if you want to be a doctor go to medical school, being a doctor means that you have to spend 11 to 15 years of post graduate training after high school, wearing a stethoscope and a white coat doesn't make you a doctor and the list goes on. NPs don't become NPs to "play" doctor. This is a profession that was borne from a need of primary care and pediatrician shortages in under-served areas. In 1...

An article about nurse practitioners from Pennsylvania's timesleader.com appears on their website today, " Popularity of practitioners growing ." The article discusses an NP practice in Kingston Pennsylvania, Women to Women, that specializes in women's health. It's great to see more and more NP practices gaining headlines. It's also great to get support from our elected leaders such as PA Gov. Ed Rendell. He was integral in expanding the NP role in Pennsylvania in the hopes of making health care more accessible. It certainly seems like they are well on their way. Patients that utilize our services appreciate the access, the patient-centered approach and the high-quality care that NPs are known for. It's also encouraging that other members of the health care team are becoming increasingly aware and accepting of our roles on the team in an attempt to fill in the many gaps in health care.