A Nurse Practitioner's View

One can find a myriad of commentaries written on the future of primary care now that health insurance reform has passed. Many of these refer to nurse practitioner led clinics and how this can be one possible solution to care for the millions of Americans that will now have health insurance. Of course, I am a proponent of NP guided care and believe that patients form long lasting partnerships with NPs to help make choices about their health and wellness. 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 ...

Here is a rather short and short-sided article written by CNN Money about an "endangered breed" of "family doctors." Interestingly, it ends with asking the question: Should specialists, nurse practitioners and physician assistants be encouraged to fill in the gap left by shortage of primary care doctors? We want to hear about your experiences. Now, the article mentions nothing about NPs or PAs yet asks for reader experiences. Fair enough. However, the barrage of degrading and insulting comments from self-identified physicians and others in healthcare are downright angry. I wonder what impact this has on their patient care.

Once again, a debate is reignited about physicians versus nurse practitioners over at A Happy Hospitalist's blog. I'm not getting into a contest of who is smarter than who. I have always acknowledged that a physician's education is longer than that of a nurse practitioner's. My education and training has prepared me for a career in primary health care - a field that I am passionate about, am constantly trying to increase access to and one that I'm good at. Primary care is part of that vision of primary health care. There are many definitions of what "primary health care" is and the one that I use is not made up by me in my fairy tale world - it is the one that the World Health Organization defines as: reducing exclusion and social disparities in health (universal coverage reforms) organizing health services around people's needs and expectations (service delivery reforms) integrating health into all sectors (public policy reforms) pursuing collaborati...