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Friday Mar 29, 2013

Physicians, NPs Should Work Together to Improve Primary Care

If one were to skim the latest headlines about scope of practice, you might think you were reading coverage from the sports pages. The media continues to inject words like "fight" and "battle" into the important discussion about independent practice for nurse practitioners.

This isn't a turf war. It is an issue of patient safety. Nurse practitioners can provide numerous primary care services that are within their scope of practice -- immunizations, screenings, management of acute and many chronic conditions, etc. -- but physicians provide the needed expertise when a patient's condition requires care beyond that level, when it is complex or ill defined. With the ever increasing complexity of care and the rising health care needs of society, collaboration is critical.

This should not be an us-versus-them debate. We should be working together.

I recently participated in a Politico panel discussion on the topic with American Association of Nurse Practitioners President Angela Golden, D.N.P., and others. Leading up to the webcast, some people seemed to be expecting an ugly scene.

Admittedly, many family physicians and nurse practitioners disagree on this topic. However, our stage was set for an intelligent conversation, not an episode of "Jerry Springer." Family physicians work side by side with nurse practitioners every day. Hostility isn't good for any of us or our patients.

I had never met the AANP's president before, and what I found during our time backstage was that we agreed on more topics than we disagreed. We had common clinical interests and had a very collegial conversation.

We're not going to agree with our colleagues -- nurses or physicians -- 100 percent of the time, and that's OK. The key is to make sure those disagreements don't interfere with patient care.

For me, that's what this issue is about -- patients.

Although nursing advocates have been quick to point out a worsening physician shortage, they have ignored the fact that our country also is facing a shortage of nurses(digitalcommons.unl.edu). You can't replace one thing you lack with something else you don't have. Primary care should be the foundation of our health care system, and our country needs more primary care physicians, primary care nurse practitioners and physician assistants working together to address both access to care and quality of care issues.

Together with our nursing colleagues, we can improve primary care and our nation's health.

Wanda Filer, M.D., is a member of the AAFP Board of Directors.

Posted at 12:43PM Mar 29, 2013 by Wanda Filer, M.D.

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