As I've stated before, NPs are not brand new to the health system and have a 30+ year history of providing high quality care. A number of NPs right now own their own practices while others can be found in school-based clinics, hospitals and physician's offices. Unfortunately, NPs face many of the same types of issues that has driven physicians out of primary care. Dr. Karen Li wrote a wonderful column, "Why I Left Pediatrics," that describes the reality of the barriers in health care.
We simply cannot expect NPs to fill the void in primary care settings while maintaining the widespread dysfunction of the health system. It will only be a losing battle as we try to care for our patients. I do however, remain optimistic that we have taken an incremental step in the right direction. We realize that maintaining the status quo is no longer an option. NPs will hold increasingly significant roles in the system. To avoid ending up in the same situation, we need to ensure that all stakeholders are at the table as we write the next chapter in health care.