Primary Care: Advanced Nurse Practitioners
In recent years, there has been a notable shortage of primary care physicians due to a number of systemic factors within the healthcare system, including the rising cost of medical school, which is driving many young physicians to choose specializations rather than the field of primary care. Yet primary care is on the front lines of protecting the health of patients. Primary care can prevent the festering of chronic diseases and is less expensive and less intrusive to the healthcare system and the patient as a whole than is secondary or tertiary care. This paper will examine the existing literature on the role of nurses in primary care and evaluate the role nurses can play in improving this area of medicine.
Synopsis of Studies
According to a 2012 study in Health Affairs journal, physicians groups have strongly opposed the expansion of the role of the advanced nurse practitioner (APRN) into primary care, arguing that physicians have unique capabilities that cannot be replicated and this will threaten patient safety. However, the objectivity of this claim has been questioned, given that a systematic review of 26 studies “found that health status, treatment practices, and prescribing behavior were consistent between nurse practitioners and physicians” (“Nurse Practitioners and Primary Care,” 2012, par. 13). In fact, arguably, the use of physicians for routine primary care overtaxes the healthcare system’s scarce resources of physicians, which can be better employed in other areas.
Unfortunately, many states still limit the scope of APRNs. But given that it takes a much shorter period of time to educate an APRN than a physician, the journal Health Affairs argues that since there is no substantive difference in quality of care or patient satisfaction and considerable cost savings and benefits, expanding the scope of primary care on a nationwide basis is vital to address the shortage. A study by Bauer (2010) likewise confirmed that, in the wake of the passage of the Affordable Care Act (ACA) which, if it continues to stand as a matter of law, will increase the demand for primary care physicians as more and more individuals have health insurance and see providers on a regular basis, APRNs offer a cost-effective...
References
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Bauer, J.C. (2010). Nurse practitioners as an underutilized resource for health reform: Evidence based demonstrations of cost-effectiveness. JAANP, 22 (4), 228-231.
Donelan, K., DesRoches, C., Dittus, R. & Buerhaus, P. (2013). Perspectives of physicians and nurse practitioners on primary care practice. New England Journal of Medicine, 368:1898-1906. Retrieved from: http://www.nejm.org/doi/full/10.1056/NEJMsa1212938
Nurse practitioners and primary care. (2012). Health Affairs Health Policy Brief. doi: 10.1377/hpb20121025.457840
Poghosyan L, Shang J, Liu J, Poghosyan H, Liu N, Berkowitz B. (2015). Nurse practitioners as primary care providers: Creating favorable practice environments in New York State and Massachusetts. Health Care Management Review, 40(1):46–55
Poghosyan, L., Norful, A. A., & Martsolf, G. R. (2017). Primary care nurse practitioner practice characteristics: Barriers and opportunities for interprofessional teamwork. The Journal of Ambulatory Care Management, 40(1), 77–86. http://doi.org/10.1097/JAC.0000000000000156
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Practice, 17 (1), 24 – 31. Retrieved from: http://journals.sagepub.com/doi/full/10.1177/1527154416645539#articleCitationDownlo adContainer
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