A Nurse Practitioner's View

As the case for nurse practitioners is becoming increasingly obvious across the spectrum, predictably, the turf battles are rearing their ugly heads. Here is a blatant  example  of the rhetoric and follows a formula that I am going to reveal to spare any future time wasting reading them. Refer to the physician shortage and mention "Obamacare"  State the obligatory, "nurse practitioners are valued as part of the health care team"  Point out the differences in education and training (for example, physicians have 1 billion hours of training where NPs have nothing even remotely close to that)  Make the inference that quality of care will somehow suffer because of the differences in education/training (though there is not one shred of evidence that proves this) Make sure NOT to mention anything about patient outcomes being the same or better when NPs are primary care providers If there is mention of outcome studies, be sure to highlight how they are "ol...

My apologies in advance for this post as I'm sure it is a bit all of the place. I wanted to just jot down some of my thoughts on the "nurse practitioner vs. physician debate." There has been many articles recently written about this, so here are my thoughts: (these of course are my own thoughts and not representative of my affiliations) Above all else, nurse practitioners want to practice at the "top of our licenses." That is, to our full education and training. Imagine having access to the most wonderful car in the world - that can not only take you to wherever you want to go, in great comfort and with with excellent gas mileage, but not having the keys to start it. That is the restriction of the collaborative agreement. NPs have the education and training to care for patients in their specialty. However, without a collaborative agreement with a physician, we can't use any of it. We are stuck in the proverbial parking lot without keys.  Nurse practiti...

My physician's group utilizes an on-line patient portal to schedule appointments, view lab results, and to communicate with my provider. Fortunately, it is very rare that I need to actually schedule an appointment. I've only been a patient of the practice for just about 2 years and I thought I'd schedule my second annual physical. (In fact, I've been there once, a year ago, for a physical on a Saturday). Now, I do question the real value of the annual physical examination but as we all get a year older, there are certain screenings that are recommended . Nonetheless, I fired up the handy patient portal web address and requested a physical examination for any early Saturday appointment in June or July. Since I do work Monday through Friday with my own patient load and responsibilities, I don't think I should need to take a day off to have a physical. The practice has Saturday hours and I thought this would be ideal for me and my schedule. This is the response that...

With the recent increased media attention regarding nurse practitioner practice, I've noticed many inconsistencies and misconceptions in the media. Here are some of my own clarifying points: Nurse Practitioner practice is not brand new. The profession has been around since the mid 1960's. Therefore, all of these intimations that we are doing something (or looking to do something) new is inaccurate. There is a 40-year history of NP practice. NPs are not individuals who one day arbitrarily started writing prescriptions. There is a standardized education , training, licensure, and certification process that allows us to perform in that capacity. There are differences in each State practice act that sets the standard for what we can (and can't) do in each state. Note that the majority of State acts have these regulations that haven't been updated to reflect current education and training. The Doctor of Nursing Practice (DNP) degree is often linked to these conversations but...

Here is a news-worthy article and clip about NP practice in New York. The piece is from East Syracuse, New York and highlights how NPs can be part of the solution to primary care shortages. Also, April is Nurse Practitioner month in New York State. This would be a fine time to recognize NP's contributions to the health care system and patient care.

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.

This is classic. On his blog, DB's Medical Rants, Dr. Bob, writes the following about the term 'primary care' and why it's a poor descriptor: "When suits, politicians, Wal -Mart and mid-level providers see the phrase primary care, they think “simple care.” They think of patients with one problem, like hypertension or even diabetes. They think of urinary tract infections, sore throats and upper respiratory infections. They think of ear aches and knee pain." See folks, us lowly "mid-levels" are grouped together with suits, politicians and Wal -Mart executives - quite the grouping! Second, Dr. Bob seems to think that we are incapable of treating anything that's not simple. Apparently, we focus on one thing only. We don't perform screenings, immunizations, mental health evaluations, make appropriate referrals, etc. Please. Why are you so sour Dr. Bob? Maybe you haven't had the opportunity to work with Nurse Practitioners and/or Physician Assi...