What is a Nurse Practitioner?

More and more frequently, when patients visit their physician's office, they may be seen by a nurse practitioner rather than the doctor.  The reason for this change is simple:  The demand for healthcare is increasing along with the size of our population, but the supply of primary care doctors is dropping.  According to the Association of American Medical Colleges, in the next 12 years the U.S. is expected to have a shortage of approximately 43,100 primary care physicians.  Because of this situation, nurse practitioners are filling the gap.

What Tasks Can a Nurse Practitioner Perform?

When I scheduled an appointment to see the dermatologist, it was a nurse practitioner who assessed my skin and removed a tiny area for a biopsy.  Since I had never been seen by a nurse practitioner before, I was concerned she might not be as qualified as the dermatologist.   As a result, I wanted to learn more about nurse practitioners and thought my readers would also want to know what I discovered.

According to an article in the July-August, 2017 issue of the AARP Bulletin, nurse practitioners can perform many of the same tasks as doctors.  Just like the nurse practitioner (N.P.) who checked my skin, they are allowed to assess patients, diagnose illnesses, order and interpret diagnostic tests (such as x-rays or biopsies), prescribe medications and give patients instructions on their treatment.  They can also perform minor surgical procedures, such as the tissue biopsy which was performed on me.  This information was a relief to me, since these were precisely the tasks which my nurse practitioner did.

While I saw an N.P. who specialized in dermatology, 80 percent of them work in the area of primary care.  The opposite is true of physicians; only 14.5 percent of them choose a primary care residency.

What Training Does a Nurse Practitioner Receive?

My next question was how well trained my nurse practitioner was.  Was she qualified to perform these tasks?  According to the article mentioned above, a nurse practitioner must have at least a bachelor's degree in nursing, be a licensed registered nurse (R.N.), obtain national certification, and submit to peer review and clinical outcome evaluations before she can be referred to as an N.P.  Their training also stresses prevention and wellness, not just treatment. 

According to the American Association of Nurse Practitioners:

"All NPs must complete a master's or doctoral degree program, and have advanced clinical training beyond their initial professional registered nurse preparation. Didactic and clinical courses prepare nurses with specialized knowledge and clinical competency to practice in primary care, acute care and long-term health care settings."

Although they do not receive as much education and training as a physician, who must receive a four-year undergraduate degree, spend four years in medical school and then commit to another three to seven years performing a residency, nurse practitioners continue to submit to "undergo rigorous national certification, periodic peer review, clinical outcome evaluations, and adhere to a code for ethical practices. Self-directed continued learning and professional development is also essential to maintaining clinical competency." (according to the AANP website).   

Are Patients Satisfied with Care Give by Nurse Practitioners?

Despite the fact that nurse practitioners do not receive as much formal education as physicians, the patient outcomes are considered comparable.  In addition, in at least one study patients rated nurse practitioners 9.8 out of 10; doctors only scored 7.2. This indicates that patients are actually more satisfied with the treatment they received from the nurse practitioners, as compared to doctors.  In my case, I was very pleased with the attention I was given by the nurse practitioner and was satisfied that she was careful and thorough.

What Else Should You Know About Nurse Practitioners?

Nurse practitioners can practice in all 50 states.  As of early 2017, they were able to practice without the supervision of a physician in 22 states and the District of Columbia, as well as within the Veteran's Administration health system. This means they can have a private practice, without a physician on the staff.  In the other 28 states, they are restricted to only being able to practice if they collaborate with a doctor.

As of this writing, there were an estimated 222,000 nurse practitioners in the United States.  Approximately 244,000 are expected to be practicing in the U.S. by 2025.  This will go a long way towards compensating for the 43,100 doctor shortage which is anticipated by 2030.

In communities where patients receive care from a combination of N.P.s and physicians, the cost of care and the number of avoidable hospitalizations have been reduced.

If you live in a rural or under-served community where there is a shortage of doctors, you are more likely to see a nurse practitioner.  However, this is not always the case.  I live in a large, urban area and my healthcare provider, Kaiser Permanente, scheduled my dermatology appointment with an N.P. rather than an MD.

Although most people seem to be very satisfied with the service provided by a nurse practitioner, you should clarify who are seeing if you have any concerns.

This new trend could help Medicare recipients in the future in a number of ways, including making healthcare more affordable and accessible, no matter where you live in the United States.

You can learn more about nurse practitioners at the American Association of Nurse Practitioners:

https://www.aanp.org

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Watch for my book, Retirement Awareness: 10 Steps to a Comfortable Retirement, which will be published by Griffin Publishing in the fall of 2017.

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