Expanding Scope for NPs Remains Controversial
Expanding Scope of Nurse Practitioners Practice Discussed
Non-physician practitioners could ease the anticipated increased demand for physicians, but broadening their scope of practice is controversial, according to an article published in Medical Economics.
Noting that more than half of practicing physicians are nearing retirement, and that, by 2025, 15 million more patients will be eligible for Medicare and more than 30 million Americans will have entered the health care system due to the Affordable Care Act, broadening the responsibilities of non-physician practitioners (nurse practitioners [NPs] and physician assistants) is one possible solution. However, this has triggered considerable debate.
According to the report, NPs have limited clinical experience (3,500 to 6,000 hours compared with 21,000 hours for family physicians), but the different training could provide more patient-centric care. However, there has been a decrease in the number of nurse practitioners entering primary care, from 51 percent in 1996 to 31 percent in 2010. Nurse practitioners can help reduce practice-volume problems and they are valuable in a team-based care model. More effort needs to be invested toward educating patients about collaborative care models and the role of NPs on the care team.
"Some doctors are anti-NPs; politically they want to protect their turf," Keith Borglum, Santa Rosa, Calif.-based health care business consultant and Medical Economics editorial consultant, said in the article. "The argument about quality of care is a fair argument. But much of the health care demanded doesn't need anywhere near a physician's expertise."