ADVANCE Blog for PAs : Nurse Practitioner

Fixing the Problem with Primary Care

Heather Simons — Fri, 13 Nov 2009 17:05:00 GMT

A recent article in The New York Times discusses how " Primary Care's Image Problem " is leading the vast majority of med students into specialties over primary care and how the patient-centered medical home model could alter the course of this alarming...(read more)

New Health Care Reform Bill Recognizes PAs

Heather Simons — Fri, 18 Sep 2009 13:22:00 GMT

In a move that gets the ball rolling for health care reform, Montana Sen. Max Baucus has released America’s Healthy Future Act of 2009. While the bill is not yet complete, it contains several provisions in favor of physician assistants: The bill treats...(read more)

PAs Could Increase Access to Abortion

Terri Schaefer — Fri, 11 Sep 2009 16:06:00 GMT

An article that originally appeared in the August issue of Contraception argues that increasing the number of PAs, NPs and certified nurse midwives who perform first-trimester abortions could help improve the declining availability of abortion care. The...(read more)

More Discussion on PAs and the Physician Shortage

Heather Simons — Tue, 25 Aug 2009 14:43:00 GMT

And so the health care reform debate continues... A recent article at Examiner.com champions PAs and NPs as a possible solution to the physician shortage. "Primary physician shortage spurs search for alternatives," by DC public policy examiner Alan Portner,...(read more)

Columnist Gets the PA Role Right

Terri Schaefer — Tue, 14 Jul 2009 17:13:00 GMT

Deseret News columnist Marjorie Cortez was spot-on in describing the role of PAs in health care in her article published this morning: I'm continually fascinated by people I encounter in medical-clinic waiting rooms who absolutely refuse to see health-care...(read more)

Can PAs Help Meet Patient Expectations?

Heather Simons — Thu, 09 Jul 2009 18:45:00 GMT

On Monday, The Philadelphia Inquirer published a column called "Waiting to see the Doc: We truly do apologize" by Rachel K. Sobel, a third-year resident of the Wills Eye Residency Program at Thomas Jefferson University. Sobel writes about the frustration...(read more)

'What Is a PA?' Redux

Michael Gerchufsky — Wed, 13 May 2009 18:57:00 GMT

While it serves nobody for us to post every published "Health Care 101: Intro to PAs" article, here's one worth mentioning. This news feature is notable not only because is it an excellent description of the profession, but also because it focuses more...(read more)

Physician Assistants and Nurse Practitioners Working Together

Stephen Cornell — Wed, 18 Mar 2009 19:39:00 GMT

The American Academy of Physician Assistants is teaming with the American Academy of Nurse Practitioners and the Society of Hospital Medicine to offer a CME titled, "Adult Hospitalist Physician Assistant and Nurse Practitioner Boot Camp."

This highly specialized and educationally intense "boot camp" will immerse hospitalist PAs and NPs in the most important Core Competencies-based topics routinely encountered in adult hospital medicine practice.

The course will take place in August in Chantilly, Va.

Link

Physicians, Nurse Practitioners, Physician Assistants and Primary Care

Stephen Cornell — Wed, 11 Mar 2009 21:06:00 GMT

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.

Will Nurses Use 'Doctor'?

Stephen Cornell — Tue, 24 Feb 2009 21:37:00 GMT

Interesting poll results from the ADVANCE for Nurse Practitioners Web site.

If you had a doctoral degree, would you use the title "doctor"?
- Yes, I earned it. (22%)
- Yes, but not with patients. (17%)
- No. (60%)

Link

NPR on 'Doctor Nurses'

Stephen Cornell — Tue, 24 Feb 2009 18:01:00 GMT

National Public Radio did a piece on the Doctor of Nursing Practice degree on All Things Considered on Feb. 22.

No one wants to badmouth Florence Nightingale, but a new degree for nurses is causing bad blood between doctors and their longtime colleagues. The program confers the title of doctor on nurses, but some in the medical profession say only physicians should call themselves "doctor."
Dr. Steven Knope is a family practitioner in Tucson, Ariz. "If you're on an airline," he jokes, "and a poet with a Ph.D. is there and somebody has a heart attack, and they say 'Is there a doctor in the house?' — should the poet stand up?" Knope laughs. "Of course not."

Is a "poet with a PhD" really equivalent to a nurse practitioner with a doctorate degree? Of course not. That's silly.

The report also briefly mentions PAs--as a threat to physicians. Not the best mention.

Here's where physicians and the new doctor nurses agree: Both groups say physicians feel threatened. They see the new breed of nurses as an invasion of their turf.
Fourth-year medical student Janet Pullockaran at University Hospital's emergency room understands the threat. "With all these new people — physician assistants, nurse practitioners coming into the field — maybe our training won't lead to a secure position in the future," she says.

It makes me wonder if the whole doctorate debate--for NPs and PAs--isn't in large part just another turf battle in a long, long line of physician turf battles.

Link

Have Nurse Practitioners "Gone Off the Deep End"?

Stephen Cornell — Wed, 11 Feb 2009 20:39:00 GMT

Physician assistant blogger physasst questions the nurse practitioner profession's move to the DNP degree.

OKEY DOKEY. I like NP's, I consider them colleagues, but I think that they have gone off the deep end with this one. First, mandating that all NP education is awarded a doctorate by 2015 is foolish. This will decrease enrollment of many potential RN's, and especially those that might be likely to practice in rural and underserved areas, where we have the greatest need. The added expenses of completing a doctoral degree will ensure that DNP graduates will seek out better paying opportunities in more attractive locales in order to pay down student loan debt.
My other concern is the use of the title, "Doctor". It is true that pharmacists, PT's, and others have moved to a doctoral degree. BUT, none of those professions outside of a psychologist, use the title "Doctor" when treating patients.....why you might ask?

Link

Call Me 'Dr. Nurse Practitioner'

Stephen Cornell — Wed, 04 Feb 2009 20:13:00 GMT

Interesting poll on the ADVANCE for Nurse Practitioners Web site: If you had a doctoral degree, would you use the title "doctor"?

Results

Health Care Providers and Recession

Stephen Cornell — Wed, 28 Jan 2009 23:45:00 GMT

On one of the ADVANCE for Nurse Practitioners blogs, a health care career expert cautions that medical providers are not immune to recessions.

Last week we talked about the effect of the recession on what is considered by many to be the most stable sector of the economy: health care. Unfortunately, we as frontline providers are not automatically guaranteed job security as evidenced by recent layoffs announced by several major health care systems.
Until the economy recovers and hospitals and clinics begin to collect on their growing level of receivables and stop writing off the uncollectables, many of us will continue to feel less than 100% stable in our positions -- and some of us will be laid off.

Link

Some Nurses in Canada Oppose Physician Assistants

Stephen Cornell — Mon, 26 Jan 2009 21:46:00 GMT

The Registered Nurses Association of Ontario is apparently not pleased with the physician assistant profession's growth in Canada.

RNAO executive director Doris Grinspun's warning about PAs: "Don't let them touch you."

The idea is meeting with resistance, however, from the Registered Nurses Association of Ontario. The group said Ontario should be training more nurse practitioners instead, because they are better educated and have more autonomy than physician assistants.
Physician assistants will have to turn to nurses or call physicians to act on medical directives when a patient's situation changes, said Doris Grinspun, executive director of the RNAO.
Grinspun said she is especially worried that some physician assistants are doing surgical procedures, which she says puts patients at risk.
I would say to my family, friends, colleagues, to the public: don't let them touch you," said Grinspun. "Make sure to ask who is taking care of you."

Link

There's a response from the Canadian Association of Physician Assistants in the article, and there are 59 reader comments on the article since Friday.