The Trouble with Nurse Practitioners

Chelsea Rice, for HealthLeaders Media , March 18, 2013

To keep up with the anticipated 712,000 new positions, BLS predicts that the nursing workforce also needs to expand by 495,500. The American Journal of Medical Quality in 2012 predicted the worse of these shortages will be in the South and West regions of the country, which happens to be where the tightest APRN scope of practice restrictions are.

2. Doctors resent them on the front lines and in the board rooms

Despite the primary care shortage, The American Academy of Family Physicians released a report in September 2012 arguing that "The interests of patients are best served when their care is provided by a physician or through an integrated practice supervised directly by a physician… We must not compromise quality for any American, and we don't have to."

"I think a lot of this turf tension is the whole prestige issue about how physicians are revered. There's a combination of things, part of it is money, and part of it is around not being the one in charge. The team approach is spreading not only the workload, but also the component of who is in charge here. But it shouldn't be like that, it should be that whoever can provide care at the time should be in charge," says Mary C. Smolenski, EdD, MS, FNP, CAE, FAANP. She is a consultant and writer on advanced practice issues and the former Director of Certification Services for the American Nurses Credentialing Center, a subsidiary of the American Nurses Association.

According to Knybel at Randstad, if an APRN decides to voluntarily leave a position, more often than not it is because he or she didn't have the support of the physician or the physician teams. She says engaging the physicians in the decision to hire more nurse practitioners are a way to avoid this conflict.

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2 comments on "The Trouble with Nurse Practitioners"

MBRose (3/27/2013 at 3:50 PM)
Perhaps it is time for physicians to finally accept that nursing is not only a valuable profession, but one that can provide high quality health care in all settings, and become our colleagues and not our overseers. Nurses have been socialized to revere MDs; however, MDs have not educated or socialized to value what nurses bring to the health care table. Time for things to change if this country is ever going to get health care back to top quality for a reasonable cost. Time for nurses to step up and speak up regarding the care provided and advocating for clients we serve in all aspects of healthcare.

Bob Lowry, PA-C (3/27/2013 at 9:26 AM)
Perhaps Ms. Rice should have included Physician Assistants in this article to give it a broader view. PAs can help fill this provider shortage. PAs work under the supervision of physicians and stress the team concept of complete patient care. More info about PAs can be found at




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