A Nurse Practitioner's View

I thought that I'd start this post with a definition of collaborate (via Merriam-Webster On-Line) : Main Entry: col·lab·o·rate Pronunciation:\kə-ˈla-bə-ˌrāt\ Function: intransitive verb Inflected Form(s): col·lab·o·rat·ed; col·lab·o·rat·ing Etymology: Late Latin collaboratus, past participle of collaborare to labor together, from Latin com- + laborare to labor Date: 1871 1 : to work jointly with others or together especially in an intellectual endeavor Working jointly with others or together. Isn't that what most providers do when caring for our patients? NPs collaborate with physicians, other NPs, physical therapists, pharmacists, nurses, etc. Physicians also collaborate amongst themselves and with other members of the health care team. I bring this up because the majority of states require a collaborative relationship between an NP and MD. (Conversely, some states use an independent practice model while others use a supervisory one). The regulations among models can vary sig

Nurse Practitioner Carla Mills has written a book entitled, " A Nurse Practitioner's Guide to Smart Health Choices ." I have read excerpts from the book and intend on picking it up. Carla injects sound advice into managing chronic illnesses and a guideline for maintaining good health. This could be a great starting point to assist us with motivating our patients onto a healthier lifestyle. It's great to see a true wholestic approach to disease management, health maintenance and promotion. Check it out!

The WSJ Health Blog posted yesterday: " Some Nurses Land Higher Salaries Than Primary Care Doctors. " The gist of the article is that a recruiting firm averaged a nurse anesthetist's salary to be $185k/year opposed to $172k/year for family physicians. Now, I'm not sure if that is a blow to the sad state of primary care in this country or is a blatant smack at nurses. Is it heresy that nurses can make more than physicians? I just get the overwhelming sense from the article and its anonymous comments that the nursing profession (and its many specialties) is undervalued, poorly understood and should be akin to the handmaiden image. Why does it always have to be us vs. them?! Ugh.

Recently , a panel of AMA delegates vehemently opposed the idea of using secret shoppers to evaluate customer service of medical practices. For those of you unaware of what a " secret shopper " is (via Wikipedia ): Mystery shopping is a tool used by market research companies to measure quality of retail service or gather specific information about products and services. Mystery shoppers posing as normal customers perform specific tasks -- such as purchasing a product, asking questions, registering complaints or behaving in a certain way -- and then provide detailed reports or feedback about their experiences. According to the article, "the secret shopper concept is not being proposed to evaluate clinical skills but the way medical professionals manage relationships with patients, from the process of making appointments to such things as explaining billing practices." Of course, this shouldn't interfere with real patients and take up valuable resources. I'm

It looks like our Australian nurse practitioner colleagues endure similar baseless attacks on quality of care from the physicians they work with. See the article in The Australian entitled, "Bypassing GPs put lives at risk." "Things will be either missed, as in not detected, or there will be a misdiagnosis, as in something in error," Dr. Capolingua of the Australian Medical Association said." The easiest thing is always to play the quality card. Scare the public into thinking they will be misdiagnosed or will get inferior care by NPs, though nothing has proven that. Our Canadian friends subscribe to these tactics too. Right on queue, the Ontario Medical Association chimes in NP quality of care: "It's a delicate balance: Sure, we want to increase access to health care, but not if it dilutes quality of care. Nurses play a vital part in health care -as a team. You can't replace a doctor with a nurse." Nurse Practitioner scope of practice doe

Benjamin Brewer, M.D. writes a regular column in the Wall Street Journal entilted, "The Doctor's Office." Yesterday, he wrote the article, " Primary Care Has Rewards Despite Hassles ." I suppose the article is intended to give you the warm and fuzzy's about what it should be like being a primary care physician today - he talks of saving lives and delivering babies. However, I guess Nurse Practitioners are among the "Hassles" that he speaks of: "The future competition from retail clinics, various physician extenders and the opening of 200 Ph.D. nursing programs that will churn out "doctor nurses" is just a symptom of our health system's ills, not necessarily a cure for them." By the way, those programs are Doctor of Nurse Practice (DNP), not PhDs. I don't believe any of those "hassles" purport to be the cure-all for the ills of the healthcare system. They are however, an attempt to address many of today's dy

One has to hand it to Massachusetts for tackling escalating health care costs head on. A bill, that has passed the Senate and will soon be introduced into the House (as reported by The Boston Herald ): "... calls for creating a statewide, electronic medical records database, allowing patients to choose nurse practitioners as primary-care providers, and prohibiting pharmaceutical company sales agents from offering gifts to physicians." Allowing patients to select NPs as their primary care providers will serve as additional entry points into an already over-burdened primary care system. In addition, the bill will enable patients to experience high-quality, cost-efficient and patient-centered care directed by Nurse Practitioners.