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Sunday, February 25, 2018
HomeHealthWhat's Missing from the Conversations about Nurse Practitioners and Primary Care?

What's Missing from the Conversations about Nurse Practitioners and Primary Care?

Source: Vanderbilt University School of Nursing;

Source: Vanderbilt University School of Nursing;

Today, Diane Rehm’s radio program included an hour-long discussion on the role of nurse practitioners with Reid Blackwelder, MD, family physician and president-elect of the American Academy of Family Physicians; Mary Agnes Carey, senior correspondent for Kaiser Health News; Ken Miller, PhD, RN, CFNP, nurse practitioner and associate dean of The Catholic University of America School of Nursing; and Sandra Nettina, MS, ANP, nurse practitioner at Columbia Medical Practice in Columbia, Md., and past president of Nurse Practitioner Association of Maryland.

There was one thing missing from this otherwise great discussion of the issues related to nurse practitioners being able to practice with full authority (without legally mandated physician collaboration or supervision). Nurse practitioners bring additional knowledge and skills to their practice that are just what primary care needs. They understand patient-centered care, listening carefully and responding to what patients and families say they need and want. They are experts in health education and counseling, as well as care coordination. These skills matter when we’re trying to transform our health care system into one that emphasizes health promotion, wellness, and chronic care management.

Most discussion of nurse practitioners’ roles center around their ability to diagnose and treat disease. They are prepared to do so with common acute and chronic conditions, and they know when to refer patient with symptoms of uncommon diseases to physicians–and without a legal mandate to do so, as has been shown in about a third of the states in the U.S. But we need a primary care system that can focus more on preventing diseases, promoting health, and helping patients to be knowledgale about and capable of promoting their health.

Diana J. Mason, PhD, RN, FAAN, Rudin Professor of Nursing

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Diana is a co-director of the GW Nursing Center for Health Policy and Media Engagement and founder of HealthCetera. She was previously president of the American Academy of Nursing. She is senior policy professor at George Washington University and the Rudin Professor of Nursing at Hunter-Bellevue School of Nursing. She is a health policy expert and leader. Diana tweets @djmasonrn.

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  • Great points about NPs and their expertise in health promotion emphasis, health teaching, health counseling, listening skills, and more…they are just right for the current scene in health care and what people really need.

  • It is important to note that 75% of visits to health care providers are for either skin problems or joint/back discomfort. And, most of those problems don’t even require a health care provider (searching the internet provides a wealth of good advice). A big issue the US faces is how to educate the public about simple problems. Most people are afraid to use over the counter medications that might help for a variety of reasons. Perhaps public school teachers could help to lessen the shortage of health providers just by adding self-treatment of simple problems and ways to stay healthy to the curriculum. As long as the primary care doctor or nurse practitoner follow evidence based guidelines I don’t care which one treats my problems.