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I am a primary care practitioner who left the field for hospital medicine. I'll say right off that I work with nurse practioners, respect them and even testified before the Georgia Assembly in favor of prescription rights. I believe that nurse practioners will help to ease the primary care crisis. However, the real problem is the undervaluing of primary care and medical care that doesn't involve procedures in general. The following problems are likely to ensue from the above. First, while most nurse practitioners had many years in practice in the past prior to entering NP school (which was rare) and there were only a few such schools, many NP's now graduate with few, if any years of actual previous nursing experience, thanks to dozens of new NP programs. NP's, except for their nursing experience, which may be extensive or not,recieve nothing like the internship and residency program physicians go through. Second, some preliminary research shows that NP's order more tests and call subspecialists more, which in the end in these studies, actually increased costs. Finally, large numbers of nurse practitioners will continue to exacerbate the nursing shortage, which is probably worse than the primary care shortage. In summary, while I respect nurse practitioners, I don't think that it will be a cure all. The real problem with primary care and nursing is the undervaluing of so called "cognitive services" as opposed to procedural services which forces up the overall cost of medicine by increasing the volume of procedures done and makes primary care not worth it. Would you triple your salary by studying for 9 years instead of 7?
By Marty
