Nurse Practitioners in Healthcare Reform
I am concerned Nurse Practitioners are getting left out of the Healthcare Reform Bills. In HELP, the Kennedy bill, there is mention. In the Republican bill there is not a mention. It is an indication to me of two things. First, the doctor lobby is very powerful. Secondly, the nurse practitioner lobby is not so powerful.
Nurse Practitioners are a much needed source of primary care providers. It is a gap that can be filled by trained and qualified professionals. Rural communities would benefit dramatically from having nurse practitioners as primary care providers. The research over the past 20 years have shown repeatedly that outcomes in the primary care setting for nurse practitioners and doctors is equal. This basically means nurse practitioners (NP) do not cause harm and know what they are doing. These results are evidence based , so what is the problem?
Part of the problem is the regulations for NPs are different in each state. Some states like New Mexico and New Hampshire have independent practice allowing NPs to have their own practice. Other states like Massachusetts require supervision by a doctor. This limits the type of practice for an NP and cannot until this year be credentialed and receive reimbursement from insurance companies. I would put forth that many doctors will not accept NPs because of their own fear and ignorance. Fear, from the an imagined loss of patients. Ignorance of not understanding the role and scope of practice of an NP and how a collegial relationship can enhance care. When all the uninsured enter the market, who will care for them? Doctors should welcome the NPs to assist with lifting the burden and create team practices as equals. NPs don't want to be doctors. A well trained NP knows the limits of his/her practice, knowledge and when to refer or ask for assistance. Health Reform won't be successful if NPs are left out of the picture.
Posted by HealthCare Whisperer at 7/26/2009 3:14 PM 
Categories: doctors scope practice,nurse practitioner,health reform
Tags: doctors nurse practitioner evidence based health reform scope of practice
Categories: doctors scope practice,nurse practitioner,health reform
Tags: doctors nurse practitioner evidence based health reform scope of practice
You have a good point, and this is a topic that is important but not mentioned at all in the media. Thank you for enlightening me.
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I found your site on Twitter. I love what this site is doing. Americans need health care advocates and not more plans.
I worked writing computer programs for a government health care plan. I finally quit because I realized that the design of employer based and government based insurance is not leading us to better health.
The better path to good health is to restore the patient/doctor. The ideal health plan simply provides resources so that patients are able to buy care when they need it.
The plan I advocate is called a Medical Savings and Loan:
http://www.MedicalSavingsAndLoan.com
This adds an interest free loan to a MSA. The motto is "Take what you need. Repay what you can."
Were people to pay for their care from their own resources, they would seek out nurse practicianser and health care advocates to help assure that they maximize the return on their investment in health.
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Thank you for your comment. It is important for consumers to know there are options that could work besides the current system. There has to be a better way.
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There is more acceptance of NPs as primary providers, however. As example, the online service www.housedoc.us recently added NPs as medical providers with whom patients can communicate on line, similarly to doctors.
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Thanks for the information. It is always exciting to find NPs being more accepted!
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I have found a number of articles which include salient and timely information which is not sifting down to the popular press. I am an NP in an underserved area in southwest Arkansas and there is not enough of me to go around. I am constantly reading, learning and applying new clinical expertise in my shared practiced with a semi-retired physician and believe me the morbidity and mortality in the community is low as a result. We see and do it all but the greatest need is teaching trust and partnership in health care among a population who are inundated with confusing information in the popular press and who try manage themselves accordingly without consulting a physcian who knows THEIR history and THEIR level of understanding. It is an art guys - let's remember to send folks for an EXAM. Can't be it and technology will never replace it. We do need all the help we can get though and guided education is the path to enlightenment and well being. can't underestimate the wisdom and value of LISTENING to folks explain their own rationale for behaving and doing as they do .... finances and tradition figure high in the mix for determining a course of action. We can work with them and accomodated dearly held beliefs or challenge them with EVIDENCE in terms they can understand. At any rate it takes a village - but somebody has to stop the buck.
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