Physicians' Stance on Nurse Practitioners is Dangerous

Alexandra Wilson Pecci, for HealthLeaders Media , September 25, 2012

Summers says the AAFP paints the picture that because APRNs didn't go to medical school, they'd miss something. But what if the opposite were true? Nurses are "so well-versed in the normal and evaluate so thoroughly" that they may be especially attuned to atypical symptoms, Summers says.

And they're so used to being part of a team that they don't hesitate to refer care to a specialist. Moreover, I have yet to hear about epidemics of patients who have been harmed by second-rate care by APRNs.

But ultimately, making arguments about "who does it better" is also counterproductive. That's because with the move toward ACOs and patient-centered medical homes, team-based care is fast becoming a way of life. And although the AAFP report ostensibly calls for team-based care (with physicians in the lead, of course), it doesn't seem very useful to suggest that some members of that team aren't up to snuff.

"If we're really going to shift to this team-based care," Summers says, "it's unfair to the public to write these sorts of things that call into question the skills and capabilities of any member of the healthcare team."

Alexandra Wilson Pecci is a managing editor for HealthLeaders Media.

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3 comments on "Physicians' Stance on Nurse Practitioners is Dangerous"

Katherine Katen Moore (1/1/2013 at 11:50 AM)
excellent comments both. What is the big deal? if MDs are so well educated, why waste that on the mundane and the routine? NPs and nurses (not as familiar with PAs, sorry) are trained to work in the daily milieu...

jsilver (9/28/2012 at 8:41 AM)
Let's be honest here. There has been a dramatic shift in the politics of the AMA. They have become increasingly hostile to sharing primary care, and it appears this corelates well with their shift to the right politically. I think this is becauise they have many physicians who do not support them, which allows the ideologues to rise to the top. I remember when the scientific comittee of the AMA recommended decriminalization of pot! Where is the MD outrage against poverty, war, or the increasing challenge to things like planned parenthood? MD's have become a self interested group and have forgotten their obligations to the public. It might surprise the AMA to find out how much we could accomplish together, if they could just get off their high horse and remember what we are here for.

Gus Geraci (9/26/2012 at 1:06 PM)
I don't see a suggestion of two classes of care, I see a highlighting of the fact that CRNP's (and PA's) are not as highly trained as physicians. Absolutely CRNP's and PA's should be allowed to practice to the top of their training, just as Family Physicians and Primary Care Internists and Pediatricisns should practice to the top of theirs. Primary Care Physicians should not have to see "routine" stuff. They should see the more difficult and complicated primary care problems, thus saving time for non primary care specialists to see the stuff they NEED to see, not the mildly difficult but the really difficult. It's time to stop throwing insults, and really work as a team. Let everyone work to the top of their licenses, and the entire system will benefit.




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