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Private Practice

There is an interesting trend that I'm observing and don't necessarily see how this is going to turn out. I'm seeing more and more nurse practitioner's opening their own autonomous practices. Many of these offices set out to offer care that is personalized, covered under insurance, and of course high-quality. I'm also seeing more NP specialty/sub-specialty practices such as house calls, incontinence, and women's health. This is in a time when more physician practices are joining together in these conglomerations that aren't necessarily tied to hospitals. You'd be hard pressed to find a solo primary care physician these days yet nurse practitioner solo practices are popping up. The talk about the formation of accountable care organizations can be attributed to health care reform and the spurring of large multi-physician practices. What to make of this? I honestly don't know. Many people and patients have said to me "you should start your own prac...
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NP Residency

The healthcare system of today is so complex yet so dysfunctional that I believe the time has come to educate and train the NP providers of tomorrow in a way that is reflective of that complexity. We have done a good job up to this point but need to bring that to the next level. Residency. I'm not necessarily referring to the typical residency training of physicians which takes place in hospitals but a residency-type of program in an out-patient setting (ironic that we use the term residency). We realize that healthcare is not exclusively delivered in hospitals. It takes place in independent providers offices, in community health centers, in mobile health vans, and in retail settings. It takes place in people's homes and places of employment. It takes place in many of the health decisions that we make on a daily basis. I found this NP residency program in Connecticut that claims to be the first NP residency in the US. The programs admits 4 NPs each year and trains them to ha...
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Precepting Students

I've precepted many NP students during the years and usually had pretty rewarding experiences. (There was that one student that just didn't get it...I guess I can save that one and how I handled it for another post!) I like to think of precepting as a two-way street: my student is getting the hands on experience of patient care with guidance while I can further hone my precepting skills. Precepting a student is not simply telling them how to treat a condition or how to prescribe a medication. It is helping that student critically think to formulate differential diagnoses and treatment plans. Precepting can often be overlooked as part of the education and training of health professionals yet it is a critical part of acquiring the necessary skill set of patient care. I think back to my experiences as a student and have found supportive clinicians that helped to shape me into the clinician I am today (I was precepted by a Doctor of Osteopathic Medicine, an OB/GYN, a family nur...
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