Nurse practitioners' growing role in your health care

[marmar]

By Anya Martin


SAN FRANCISCO (MarketWatch) - If you haven't had an appointment with a nurse practitioner yet, chances are you will within the next few years.

Nurse practitioners, or NPs, rank as one of the fastest growing health-care professions, with about 140,000 qualified to practice in the U.S., up from 125,000 in 2008, according to the American Academy of Nurse Practitioners (AANP).

NPs, registered nurses with a master's degree, are trained to perform many of the same tasks as your family physician. They cost the health-care system less, provide similar or sometimes better quality care and patients tend to be just as satisfied with their service, studies suggest.

Regulations vary from state to state as to how much autonomy NPs may have, but most practice under a doctor's supervision and only about 10,000 NPs run their own practices in the 11 states that allow it.

Stressing patient-safety concerns, the American Medical Association opposes any regulatory changes increasing NPs' autonomy. But both clinical need and research to the contrary ultimately will trump a turf war between doctors and NPs, said Jeffrey C. Bauer, a medical economist with Chicago-based Affiliated Computer Services Inc. ...........(more)

The complete piece is at: http://www.marketwatch.com/story/nurse-practitioners-growing-role-in-health-care-2010-06-02

[charlesg]

1. NPs are great

We need more NPs and PAs for sure. They don't have the God complex, and they can definitely handle most ailments. Let them practice independently.

[Liberal_in_LA]

27. I love 'em

[CaliforniaPeggy]

2. I LOVE my NP...

I started to see her when my MD was out sick with melanoma. After he died, I just continued with her. She is the best.

She still works for a doctor, but I rarely see him. I decided to visit him instead of her just to get acquainted, and he was fine.

I'll be seeing her this week, in fact, for my annual grope (pap smear) and my bone density test.

:hi:

[Liberal_in_LA]

28. NPs are great

:toast:

[Cleita]

3. My doctor has an NP whom I see now and then instead of her. She can

usually help for routine health matters and write a prescription, which is often all I need. If it's something she can't handle, she brings in the doctor for her opinion. A NP in a clinic out in the boonies actually correctly diagnosed what was ailing my husband, when other doctors missed what was really going on with him. She ordered the right tests and came up with the right diagnosis. Then she referred us to a specialist to treat him.

[nichomachus]

4. Another vote for NPs and PAs

They can actually spend time with you, listen to you, and discuss with you. They don't have to hustle you out the door in 7.45 seconds to meet their quota of patients.

I see an MD now, but for years saw mostly NPs and PAs -- loved every minute of it and got great care.

[pinboy3niner]

5. And another

My BEST care at the VA has come from PA's.

[SocialistLez]

10. Yep, my NP listened and wasn't trying to rush me out. NT

[pinboy3niner]

11. My PA will spend an hour or more with me, when necessary

Part of it involves checking out every issue thoroughly, and part involves him being meticulous about recording his notes--meaning we won't have to waste time in the future re-covering old ground, and there's a lot less chance that something will be overlooked.

[SocialistLez]

17. Oh wow. An hour is a luxury.

My longest appointment was 30 minutes.

[Hardrada]

6. I read this as "Norse practitioners" and it gave me images

of blondes checking on my vital statistics.

[leftofcool]

8. That sounds like wishful thinking to me. LOL!

[pinboy3niner]

9. You WISH! LOL

[johnaries]

20. Ya know, when I turned 50 and had to schedule a full exam, they

asked me if i would prefer a woman or a man, I thought to myself "if I'm going to pay for someone to grab my balls and stick their finger in my butt, it had BETTER be a woman!"

Actually, I scheduled it with my regular female NP, because I trust her.

[sarge43]

7. Another vote for NPs

Mine is a sweetheart; she zeroed right in my health problem and corrected it.

[madamesilverspurs]

12. It was a NP

who spotted my cancer at a very early stage, and thanks to that I'm still here. And Mom has a PA who is terrific with her, listens to her and kids with her -- and he translates from doctorspeak to comprehensible. My docs are great and the NP is a major bonus.

-

[blondeatlast]

13. NPs are a blessing to anyone who has a chronic illness like me (Insulin dependent diabetes).

I can always count on a call back within a few hours and almost always an appointment the same day if necessary.

[jody]

14. Perhaps 60-90% of the cases in ER could be effectively handled by NPs and that would be a tremendous

cost reduction.

[blondeatlast]

15. Triage IS handled by NPs and RNs, not doctors. It already saves ERs

a bajillion, it's just that since it is standard practice, we don't realize how much money it saves.

[jody]

16. Not in all states. n/t

[johnaries]

18. I PREFER NP's!

I went to an MD for a while, but he was an idiot. I switched clinics and since have had 3 different NP's (one moved out of town, and another was just a fill-in while my regular NP was on vacation). They have all been AWESOME! And they have been more knowledgeable than my old MD - they were able to answer questions he couldn't. I trust my current NP implicitly.

[RB TexLa]

19. I'm for anything that causes health care providers to have less of my money.

[Gormy Cuss]

21. It looks like I'll be the first dissenting voice here, but NPs aren't MDs

and sometimes the difference matters. Had a very bad experience in my family, in a state where NP can have their own practices, where not one but two NPs treated a single symptom and missed the big picture even though the patient described symptoms that contraindicated the condition diagnosed by the NPs -- I was there for one exam and know exactly what the patient said. The miss by the NPs delayed treatment for six months and limited the chances that said treatment would extend life for an always fatal condition. I'll add that my own health care provider's website tools for deciding when to see a physician made it clear that the combination of symptoms indicated something beyond the minor illness diagnosed by the NPs, which suggested to me that the NPs SHOULD have figured it out.

Now that's not to say NPs don't have a role in health care provision --for your basic pokes and shots, NPs are more accessible than MDs. They're just not a substitute for a doctor.

[Change Happens]

23. Some NPs know much more than doctors...nt

[Gormy Cuss]

26. Most don't. n/t

[Mojorabbit]

29. As a retired critical care nurse

married to a family doc I will disagree. There are a boatload of things a NP or PA can handle very well. There are a boatload of things a doc will handle best. They complement each other but neither are a substitute for the other.

[old mark]

22. My personal "doctor" is an NP-she is a specialist in diabetes and has been

a great help to me. I have actually seen my MD one time in the last 2 years I have been going to that practice. (She is very good, too.)


mark

[Change Happens]

24. NPs do it better!!!

IMHO

[pecwae]

25. Have had the best care from NPs & PAs

When I can choose between an MD or one of the above I always go for one of the latter. They always seem to have more time, to care and to LISTEN to all my concerns. Yes, they actually do listen to what I'm telling them. MD's could learn quite a bit about the meaning of the term 'patient care' from an NP or PA, if they wanted to know.