Reading the front page story in the Utica OD today brings up the primary care shortage, but fails to acknowledge "Nurse Practitioners" and the hard work we do in helping fill the void. I have sent the reporter Elizabeth Cooper the response below, since there needs to be balanced reporting on patient choices.

Nurse practitioners filling primary care void

Evidence shows patients receive quality health care

Markwardt is president of the Mohawk Valley Chapter of the Nurse Practitioner Association of New York State, and one of 13,000 nurse practitioners in New York State. "We're not medical doctors. We're not trying to be doctors,” said Markwardt. Our education and clinical experience has well prepared us how to “diagnose and treat, order tests and interpret tests." With a foundation in nursing our focus is on looking at the patient beyond their disease process with a holistic approach. With a nationwide shortage of primary care physicians, the Obama administration hopes an increased number of nurse practitioners could help. “We are not trying to replace primary care providers, but we fill the void for patients primary care providers may not want to see," Markwardt said. With 6,000 new nurse practitioners graduating each year, Markwardt says there won't be a shortage.

Nurse Practitioners are health care professionals who provide the patient and/or their family with comprehensive, personalized health care. They are registered nurses with advanced education and clinical training both in primary care and in a variety of specialties. NPs are an essential part of the health care delivery system by improving access to affordable, quality health care. Many Nurse Practitioners have Masters and Doctoral Degrees plus many years of clinical experience as Registered Professional Nurses. According to Markwardt, NPs provide patients not only improved access to health care, but a choice in their health care. Professionally, whether a medical doctor or nurse practitioner all health care providers are expected to collaborate with the health care team with the care being patient centered.

Many states have already eliminated the need for a written collaborative agreement currently required by New York State between a physician and nurse practitioner in light of the fact all health care professionals should be collaborating to benefit the patient. In as many as 16 states nurse practitioners practice independently. Collaborative agreements simply provide an agreement in which the physician provides a chart review set by the NP and physician at least quarterly and is available for consultation if the need arises. This is no different than a physician’s need to request consultation from a specialist for a complicated patient. However, over the years this relationship has been blurred by political interests and not the rights of patients to choose. Nurse Practitioners have been health care providers for over 40 years and bring the unique background of nursing to health care! 

Markwardt, who has a Doctoral Degree himself reports that the DNP (Doctor of Nursing Practice) focuses on taking current research and applying it into the practice setting to provide quality evidence based care for patients.

As a result of the unique focus of NP’s, patients who choose NP care often have fewer emergency room visits, shorter hospital stays and lower medication costs while reporting an extremely high level of satisfaction with the care they receive. Nurse practitioners are the invisible providers in healthcare. They have worked tirelessly as primary-care providers of underserved urban and rural patients in neighborhood health centers since their inception in the 1960s. Healthcare plans, and many private practices in the area, have always employed nurse practitioners extensively on teams with physicians to provide primary care as well as care to chronically ill patients, but often do not list them as providers. This too is changing as our physician colleagues are recognizing the value and quality nurse practitioners bring to the practice and patients.

References:

Sullivan v. Edward Hospital, 209 Ill. 2d 100, 111-127, 806 N.E. 2d 645, 653-662 (2004).

See, Jessica McCann, et. al., “Physician Assistant and Nurse Practitioner Workforce Trends,” The Robert

Graham Center, No. 37 (September 2005).

“What Works: Healing the Healthcare Staffing Shortage,” PricewaterCoopers’ Health Research Institute

(2007), http://www.pwc.com/extweb/pwcpublications.nsf/docid/674D1E79A678A0428525730D

006B74A9; see also, Richard A. Cooper, “New Directions for Nurse Practitioners and Physician Assistants in the Era of Physician Shortages,” Academic Medicine, Vol. 82, No. 9 (September 2007) (“Indeed, a major impediment to training more NPs is an insufficient number of faculty.”).

 

Additional Resources:

 

New York State Nurse Practitioner Association – www.thenpa.org

American Academy of Nurse Practitioners- www.aanp.org

American College of Nurse Practitioners- http://www.acnpweb.org/i4a/pages/index.cfm?pageid=1