Stopping the Debate on Nurse Practitioners as Primary Care Providers
(June 2009)
The opportunity for health care reform under President Obama has yet again raised the question of the need for more primary care providers. The Obama administration is looking for ways to fill this gap while meeting the health care needs of an aging population and millions of uninsured people who would gain coverage under universal healthcare proposals. The assumption is that reform will lead to the need for more preventive and chronic disease management services performed by primary care providers.
While the Obama administration has discussed strategies to increase the numbers of primary care clinicians, the rhetoric has been focused on the training of more physicians. And, yet again, as nurse practitioners have raised their voices to be part of the solution, physicians are pulling out the old ‘nurses are not physicians and they can’t be trusted to deliver safe, cost-effective care’ refrain. While this response is, I suppose, expected, the frustrating part is that in an era of ‘evidence-based medicine’, this stand by physicians simply ignores countless studies published over several decades that demonstrated that care provided by NPs achieve at least equal patient outcomes as that of physicians in addition to higher levels of patient satisfaction and trust.
I have been a nurse practitioner for over 30 years, and it is frustrating that we continue to fight these turf battles with our physician colleagues. The solution to the health care crisis in the United States must be based in collaborative care that recognizes the skills and abilities of educated primary care providers, including nurse practitioners. I hope all nurses will advocate for the roles of nursing in a reformed health care system, and look forward to the day when this debate will be a thing of the past.
NPs are well prepared to assess and diagnose health problems, prescribe medications, and partner with patients to manage primary health care problems. Just as physicians do, NPs also refer patients to specialists when needed and continue to coordinate their care. NPs already provide excellent primary care services to many of our nation’s most underserved citizens. We urge President Obama and other legislative leaders to expand the use of highly educated NPs to solve the impending lack of primary care providers in the United States. |
