The Role of Nurse Practitioners May Expand

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The U.S. is facing an extreme shortage of primary care physicians and some policymakers want to fill the growing gap by expanding the role of nurse practitioners. However, the two professions are currently occupied in a debate over who is better and more qualified to deliver patient care.

The results of a recent survey were reported in the latest issue of the New England Journal of Medicine.

Leading experts did expect some slight controversy, but they were surprised by how much doctors and nurse practitioners vary in their opinions. Among the nearly 1,000 doctors and nurse practitioners surveyed they were most divided on who provides a higher quality of care to patients: Two-thirds of physicians said if a doctor and nurse practitioner provided the same service, the doctor would do it better. Very few nurse practitioners agreed with that opinion.  82 percent of nurse practitioners felt that nurse practitioners should lead their own practices, while only 17 percent of doctors agreed.

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"We weren't surprised that there were differences in their opinions, but we were surprised by the magnitude of the difference," said lead researcher Karen Donelan, a senior scientist at the Mongan Institute for Health Policy at Massachusetts General Hospital, in Boston.

Dr. David Blumenthal, co-author of an editorial published with the study, agreed.

"It's striking how different their perceptions are, even though they work in the same physical environment," said Blumenthal, president of the Commonwealth Fund, a New York-based foundation that supports research on health policy.

Blumenthal and Donelan agree that the divide between doctors and nurse practitioners will have serious implications on the future on health care in the U.S., and the shortage of primary care practitioners is already at a staggering 33k.

A study revealed that 16 percent of U.S. adults have to wait, on average, at least six days for a doctor’s appointment when they have health problems that need immediate attention. The shortage will become far worse when the health care reform extends coverage to 30 million more Americans.

By some estimates 12 nurse practitioners can be educated for the same cost as one doctor, and there is evidence that nurse practitioners perform just as well as doctors.