As California health systems take steps to develop medical home models of care, nurse practitioners are expected to play a greater role in providing primary care services, the Los Angeles Times reports.
Medical homes emphasize a team-based approach with the primary care provider serving as the team leader coordinating care. The federal health reform law encourages the development of medical home models.
California is one of 23 states that allows nurse practitioners to provide some primary care services without physician supervision.
Six California regions have a shortage of primary care doctors, according to a 2010 report from the California HealthCare Foundation. CHCF publishes California Healthline.
The American Association of Medical Colleges estimates that there could be a shortage of 45,000 primary care physicians nationwide by the end of the decade.
Support for Greater Role of Nurse Practitioners
Nurse practitioners have advanced degrees and can perform many of the duties of primary care physicians. They also generally cost less to train and are easier to recruit.
Last fall, the Institute of Medicine released a report calling for officials to expand the scope of practice for nurse practitioners. The report found that health systems that increased nurses’ responsibilities generally provided “safe, high-quality primary care.”
Opposition to Greater Role for Nurse Practitioners
James Hay, president-elect of the California Medical Association, said some health systems have found that nurse practitioners can be more expensive than physicians because they are more likely to refer patients to specialists and order unnecessary tests.
Rebecca Patchin — anesthesiologist at Loma Linda University Medical Center and board member of the American Medical Association — said health systems should work to stem the shortage of primary care physicians through other means besides expanding the role of nurse practitioners (Hennessy-Fiske, Los Angeles Times, 3/29).
Well, i guess we all just need to do a little more footwork before we take any plunge that may cost us unnecessarily.
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