Physicians, Nurse Practitioners, Physician Assistants and Primary Care
There seems to be a bit of a stink about the new American College of Physicians policy monograph about nurse practitioners in primary care.
Overall, the conclusions seem pretty tame. The ACP acknowledges the NP role in primary care, but believes that NPs should work in collaboration with physicians as part of a team.
NPs, of course, won't like the opposition to independent practice, but the ACP seems willing to grant NPs a substantial role in providing primary care in the United States.
Here's the monograph's conclusion:
The future of health care delivery will require multidisciplinary teams of health care professionals that collaborate to provide patient-centered care. The key to high performance in multidisciplinary teams is an understanding of the distinctive roles, skills, and values of all team members. Just as the ACP celebrates the special attributes and capabilities of advanced practice nurses, it recognizes the unique role that a personal physician plays in patient care. Advanced practice nursing should not substitute for nor replace primary care medical practice as provided by general internists, family physicians, and other physicians. Physicians and NPs not only share a commitment to providing high-quality care, but also face similar challenges regarding reimbursement and workforce outlook. Recognizing and building on the common ground between the two professions is vital to improving collaboration to meet the complex health care needs of the population.
Pretty tame stuff.
The PA uproar seems to center around the fact that the ACP did not write a similar monograph about PAs. The problem with that is, PAs haven't given the ACP a reason to write such a monograph.
The NP profession has been and remains aggressive in trying to expand its role in medicine. That kind of aggressiveness demands a response.
The official PA attitude has been, "We're OK with whatever the physicians decide." While that doesn't alienate physicians, it doesn't provide cause for any kind of response.
PAs and NPs are different beasts with two different approaches. NPs are the squeaky wheel, so to speak. PAs prefer not to draw too much physician attention.
At least that's my take.
Click here for the entire ACP policy monograph.