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Family Physicians Rap 'Stopgap' Use of Nurse Practitioners

John Commins, for HealthLeaders Media, September 24, 2012

A report that warns against "stop-gap" substitutions of nurse practitioners for primary care physicians may have rekindled the long-smoldering border skirmish between the clinician associations.

The report, Primary Care for the 21st Century, was issued this month by the American Academy of Family Physicians, and reaffirms its support of physician-led, patient-centered medical homes as the best method of transforming primary care delivery.

In sharp contrast, the AAFP says advocating "independent practice by a single health professional," namely nurse practitioners in place of physicians, "flies in the face" of studies supporting the cost-effectiveness and quality outcomes of the physician-led care team approach.

"We are not trained to do the same things, so to imply that one can substitute for the other is just incorrect," Roland Goertz, MD, chair of the AAFP Board of Directors, told HealthLeaders Media. "The educational backgrounds are different. Even nursing leadership says 'we are not trying to be doctors,' but policy setters tend to simplify things, which is a kind way of saying it."

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2 comments on "Family Physicians Rap 'Stopgap' Use of Nurse Practitioners"


Dee Swanson DNP FNP (9/25/2012 at 12:55 PM)
There is no data or research that documents the need for the length of time that a physician must study before becoming competent to provide primary care. The is more than ample data that supports the safety and competence of NPs as providers of primary care. This is about power, control, turf and money as it always is with physicians.

Dr Reg Broekmann (9/25/2012 at 3:21 AM)
In South Africa we are piloting a new PHC system in which PHC nurses are connected to a designated Family Health Practitioner via a sophisticated communication system. Clinical discussions result in learning and improvement on PHC nurse competence and referrals are authorised by the Family Health Practitioner. The FHP then can monitor the progress of each referral and will give feedback to the PHC Nurse on the final diagnosis and treatment - another learning experience.