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 Provided by Clinician 1
I am in a quandary as I write this. Part of me is elated...part of me is fuming. I will surely tick off some people if they finish reading this. Got your curiosity peaked?
Recent media coverage has expounded on the wonderful fact that 28 states are considering expansion of the Nurse Practitioner role, and Dr. Bernadine Healy, the Health Editor and columnist for the US News & World Report has stated her opinion that NPs are well-suited to deliver primary care to the public. The Macy Foundation released their non-partisan opinion that NPs, PAs, and physicians should all be part of the primary care partnership, and that barriers that impede our practice should be removed.
Other articles highlight the wonderful fact that NPs are being recognized by insurance and the government as leaders of primary care practice and eligible for reimbursement. We are also key providers and leaders of Nurse Managed Health Centers (NMHC). A $50 million grant program will help innovative safety net providers.
So why am I fuming?
Because other media outlets (such as FOX) and, yes, commentary by actual NPs and certain misinformed people have made us look...less than stellar. Which we most definitely are NOT.
Dee Swanson, the AANP president, had an opportunity to speak on Fox today about Nurse Practitioners increasing role in healthcare as PCPs. While she was relatively poised during the interview, she was not really given a chance to expound on what we do, and, in my humble opinion, she did not answer a big question put to her: what IS the difference between a Nurse Practitioner and physician. She answered by saying the issue is “really access to NPs.” Unfortunately, she only had time to answer poorly-researched questions by two interviewers...neither of whom really seemed to have any understanding of our role in health care.
Yes, I know...time constraints of an interview notwithstanding. We were referred to as “registered nurses with extra training.” No mention of most of us having MSN or doctorate degrees, nor that by 2015, that the DNP will be the standard degree. The male interviewer was dismissive with his comment, “I see the NP for a prescription for a runny nose.” The female one asked if a patient should see an NP for a cold and a physician for “something more serious, like strep throat” I have to admit, I just about choked at that. And of course, the question, “what if you want to see a doctor” and you come in, expecting to see the doctor, and find out you are seeing the NP?” Ms. Swanson answered that last question appropriately – patients are and should be informed ahead of time whom they are seeing.
Ms. Swanson did mention that we NPs have been seeing patients, diagnosing and prescribing for them for 40 years; this is nothing new. She also stated that NPs and doctors have their own patients in many practices, and we are cost-effective and have the ability to manage chronic illness & “keep patients out of the ER and the hospital.”
Unfortunately, the male interviewer’s response at the end of that interview was, “yes, make them feel better and healthy.” Nowhere was there any acknowledgment of all of our talents and resources. What was sorely lacking in the interview was the fact that the public was NOT educated about what a NP really does...or that many patients prefer to see us because of taking more time, listening to their concerns, etc.
There was also a terrific piece posted in USA Today about the 28 states considering an increased role for NPs. Unfortunately, I must admit that I cringed when I read an NP comment, “We’re just like physicians, except for the pay.”
Perhaps this quote was taken out of context. Or perhaps she was joking, which did not come through in the article. I feel, however, that I am NOT like a physician. I correct any patient who calls me “doctor” and continue the patient education on what I do. My education and background is different. Yes, I make a lot less money than a physician. I wonder, however, what lay people reading that comment must think.
So where does all this leave us? A few goals:
Goal #1: We MUST continue to educate the public on our role.
Goal #2: We MUST be mindful of our actions and words, especially now that the media spotlight is on us. Which is a wonderful thing. We just need to be mindful that what we all “know” in the NP world is not necessarily understood by those who are not familiar with what we do.
Goal #3: We MUST continue to contact our legislators about the health care changes and reimbursement issues we face daily.
Comments welcome. The flame-retardant suit is on.
Some references:
http://www.usatoday.com/news/health/2010-04-16-nurse-doctors_N.htm
http://www.usnews.com/education/best-medical-schools/articles/2010/04/15/the-new-doctors-in-the-house.html
http://www.josiahmacyfoundation.org/documents/jmf_ChairSumConf_Jan2010.pdf
http://www.disruptivewomen.net/author/pcipriano/
Kim Spering is a family nurse practitioner who currently works at Brndjar Medical Associates, P.C., a family practice in Emmaus, PA. Her past experience includes the fields of medical/surgical ICU, open heart/trauma ICU, labor and delivery, nursing education, nursing supervision, and as a nurse practitioner in both family practice and OB/GYN settings. She currently serves as a NP preceptor for her graduate school alma mater, DeSales University, as well as for local baccalaureate programs. She is passionate about patient education and helping patients understand that they are ultimately responsible for their own health. She also firmly believes that the public needs to be educated on the value of NPs and PAs in meeting the health care needs of the next decade and beyond. In her free time, Kim enjoys family vacations with her optometrist husband, Mark, and her two sons, Matthew and Connor.
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