Monthly Archives: August 2014

Ten Things Physicians Should Know about Nurse Practitioners

Ten Things Physicians Should Know about Nurse Practitioners

The U.S. is home to more than 192,000 nurse practitioners, with more than 14,000 new graduates every year. Nurse practitioners are an important part of the healthcare system. Here are 10 things physicians should know about them:

  1. Nurse practitioners (NPs) are educated using the nursing model. NPs are advance practice nurses — healthcare professionals who have achieved licensure and credentialing well beyond their roles as registered nurses. All NPs obtain graduate degrees, and many earn additional post-master’s certificates and doctoral degrees. NP education provides theoretical and evidence-based clinical knowledge and learning experiences. It emphasizes development of clinical and professional experience necessary for comprehensive primary-care and specialty-care practice in a variety of settings. A distinguishing component of NP education is its concentration on the specialized needs of patient groups.
  2. Nurse practitioners diagnose, treat, and prescribe medication. Nurse practitioners evaluate patients, make diagnoses, order and interpret diagnostic tests, and manage acute and chronic conditions. Additionally, NPs offer a distinct, holistic approach to healthcare that considers the whole patient and all his needs: physical, psychological, social, and others. Over the last four decades, NPs have practiced with prescriptive authority in all 50 states plus the District of Columbia. Independent research has confirmed the safety and efficacy of this care.
  3. NPs can practice autonomously in 19 states and in the District of Columbia. Nurse practitioners treat patients autonomously — without physician oversight — in 19 states plus the District of Columbia. This is the model recommended by the Institute of Medicine and National Council of State Boards of Nursing. Many nationally recognized policy organizations and government bodies — the Federal Trade Commission, AARP, Institute of Medicine, National Governors Association, and National Conference of State Legislatures — call for more independence for nurse practitioners across the country.
  4. Nurse practitioners want to be nurse practitioners. Becoming a nurse and then pursuing higher education to become an NP is clearly a personal choice. NPs do not want to be physicians; they are committed to nursing as a profession. In fact, a U.S. News and World Report list of the top 100 jobs for 2014, ranked nurse practitioners as #4.
  5. The majority of nurse practitioners choose primary care — many in underserved areas. While nurse practitioners pursue advanced degrees and specialties in many areas, including acute care, neonatal, oncology, and psych/mental health, the vast majority (88 percent) are prepared in primary care. Almost 50 percent choose family health; 20 percent pursue adult care; 9 percent women’s health; almost 9 percent pediatrics; and 3 percent gerontological. Many practice in underserved areas, including rural and frontier settings.
  6. The nurse practitioner workforce in the U.S. is expected to grow dramatically. According to a Rand Corporation study published in July 2012, the nurse practitioner workforce is expected to reach 244,000 by 2025, an increase of 94 percent from 2008. The American Association of Nurse Practitioners estimates that the U.S. is currently home to more than192,000 NPs, with more than 14,000 new NP graduates every year.
  7. More than 45 years of research has consistently shown positive patient outcomes for NPs. Nearly 50 years of peer-reviewed, independent analyses show that the outcomes of nurse practitioner patients are equivalent and sometimes better than those of physicians.
  8. With each passing year, nurse practitioners are playing a larger role in America’s healthcare system. In 2013, more than 900 million visits were made to nurse practitioners all across the United States. The data also show that patients are consistently more satisfied with the care of nurse practitioners citing their holistic, patient-centered approach; the added health education and counseling; and the overall extra time spent with patients.
  9. Nurse practitioners are no longer the new kids on the block. After 50 years as a profession, the role of the NP continues to respond to changing societal and healthcare needs of Americans. As leaders in primary and acute healthcare, we embrace our roles as providers, mentors, educators, researchers, and administrators.
  10. Collaboration does not require regulation. Even as NPs strive for autonomy in all 50 states, every day physicians and nurse practitioners treat each other with respect, professionalism, and congeniality across diverse healthcare settings. This collegial rapport is essential for the best possible patient care. NPs are committed to ensuring that these bonds endure.


Source: Physicians Practice

Will PAs and NPs be the key to ACA, Accountable care?

Will PAs and NPs be the key to ACA, Accountable care?

A flood of new patients insured under the Affordable Care Act will strain the schedules of physicians already under siege by workflow changes, quality reporting initiatives, and increasing pressures to be even more efficient with even fewer resources. How can providers ensure that patients receive quality care without camping out in the waiting room for hours?

Many are turning to mid-level providers, including physician assistants (PAs) and nurse practitioners (NPs) to lighten the load of MDs while providing thorough primary and preventative care.

  • Only a small percentage of patients need the in-depth care of a specialist or highly-trained physician. The majority of routine care or sore throats and runny noses can be handled by a physician assistant or nurse practitioner, especially under the Affordable Care Act.
  • Allowing NPs and PAs to treat less complicated cases can keep costs down, since mid-level providers tend to collect smaller salaries, but can help bring in more patients.
  • As providers continue to invest in EHRs and are beginning to incur financial penalties based on poor outcomes under the Accountable Care models, NPs and PAs are becoming more and more crucial for a practice’s success.
  • NPs and PAs are already seeing between 16 and 18 patients on a typical day, according to a recent survey and few respondents think that number will decrease any time soon.

While many practices are still working out the optimal balance of autonomy and physician oversight, mid-level providers are taking on the role of care coordinators, as practices shift towards abiding by the principles of accountable care.  As patients become more involved in their own care, mid-level providers can help them find and understand information in a way physicians don’t always have time to do. Patients like getting handouts; they like to know what’s going on and who to call if they have questions.  They need to know what’s going on when they leave the office, and they like the feeling of knowing someone hears them and is addressing their concerns, as well as keeping them informed.

PAs and NPs are perfectly poised to fill the gaps created by healthcare reform, offering routine services that can free up physicians to do even more work.  As the true impact of the ACA starts to come into focus, mid-level providers may be the key to the effective implementation of expanded coverage and Accountable Care.