Saturday, July 03, 2010

Nurse Practitioners As Primary Care Providers

I am a primary care provider. I am the one patients come to see when they or their families are sick. I treat acute and chronic illnesses and provide counseling in mental health. I should be the one listed on my patients medicine bottles, not my collaborating MD. The quote below is my response to "The Nurse Practitioner Will See You Now" by Susan Yox Editorial Director, Medscape Nurses.

"I have worked in a rural health community for the last two and half years in Family practice as a nurse practitioner. For the first year, I was the only medical provider in the branch and it grew by leaps and bounds. I had telephone contact with my collaborating MD and he would come to the office if I needed to have him cosign a chart. One of the M.D.s in the company started working with me one day a week in order to facilitate the controlled substance needs. It was almost a year before we could find a full time D.O. to come work in the rural setting. It was difficult to recruit even though we are not far from one of the biggest medical schools in Florida (University of Florida). The only reason I needed a medical physician was the shear volume of patient numbers as the practice grew, not because I needed someone to "supervise" me as a medical provider. We have a great working relationship and we collaborate with each other. That's the way it's supposed to work. I really get tired of the turf wars that are happening on the state legislative level. I think that most doctors and NPs/PAs work well together through close contact and mutual respect. Our company employs physicians, NPs and PAs to care for our local communities and we do an awesome job, in my opinion, without the bickering between the disciplines. I wish more physician students would come to the office to see how it's done out here so that they would feel more comfortable with the "other medical providers". As more and more new MDs/DOs realize what quality care we provide, the current American Medical Association's attitudes against nurse practitioners providing primary medical care will diminish as they get older and are replaced by the younger doctors. We must remain active in our contacts with the next set of congressmen and senators that are going to be elected and find out early what their opinions are before they are jaded against us. I have already spoken with two runners in my area and plan to make a trip to Tallahassee to speak with a few in person with data in hand to show that we are competent and that patients trust us to take care of them and their families."


  1. Have you ever read "From Silence to Voice"? I think you would enjoy it. I am reading it for my health care policy class. It talks a lot about nurses getting their voices heard and impacting policy changes important in nursing. Its contents might help you when approaching legislators.

    Fortunately, the state I reside has little restrictions for NPs. We are a very rural state. There are some towns that haven't had a physician visit for years. And we have lots of independent NP clinics too. It's nice.

  2. Thanks for the book title T Rex Mom. I will find it and read it. As I am getting "older" in my profession, I am finding myself becoming more politically minded.

  3. I'm very interested in seeing how this 'bickering' progresses.
    It should be interesting.

  4. "Silence to Voice" totally rocks. A huge eye-opener. Should be required reading in every nursing program.

  5. Sean, I am interested in how it turns out too but I hope that it happens soon for our patient's sake.

  6. Kim, Glad to see you here! I have to check it out soon.

  7. Anonymous2:59 PM

    I was wondering if you could please answer a couple of questions for me. I am a student FNP in Florida. For one of our classes we are learning about the role of the NP. These answers can be brief..anything will help. Thanks!

    Do you provide consultation in your practice? Do you use consultants?

    What information and health care technology do you use in your practice?

    What methods are used to evaluate your advanced nursing practice?

    What methods for continuing education do you use?

  8. Nurses are the real primary care providers. Doctors just diagnose and perform operation and we are the one who ends up taking care of them and talking to them which the doctors often forget. I am truly happy to see your blog and learn. I notice that I am pretty naive with things around me.

  9. Anonymous4:14 AM

    Nice post.