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Physicians' Stance on Nurse Practitioners is Dangerous

Alexandra Wilson Pecci, for HealthLeaders Media, September 25, 2012

If all of this sounds familiar, that's because it is. It's the old he-said-she-said argument that keeps raging, despite the fact that a growing number of states allow for licensure of independent nurse practitioners, despite the fact that organizations from the National Center for Policy Analysis to the Institute of Medicine have called for the expansion of APRN's scope of practice.

But what makes this report a little different—and maybe a little dangerous—is that it puts forth the idea that nurse practitioners provide second-rate care.

"The interests of patients are best served when their care is provided by a physician or through an integrated practice supervised directly by a physician," report says. "We must not compromise quality for any American, and we don't have to."

"The subtext is 'don't get fooled,'" into getting second-class care, Lisa Summers, CNM, DrPH, a senior policy fellow at the American Nurses Association, told me. "The thing that bothers me about that is that it feeds into this [idea that] there are two classes of care."

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3 comments on "Physicians' Stance on Nurse Practitioners is Dangerous"


Katherine Katen Moore (1/1/2013 at 11:50 AM)
excellent comments both. What is the big deal? if MDs are so well educated, why waste that on the mundane and the routine? NPs and nurses (not as familiar with PAs, sorry) are trained to work in the daily milieu...

jsilver (9/28/2012 at 8:41 AM)
Let's be honest here. There has been a dramatic shift in the politics of the AMA. They have become increasingly hostile to sharing primary care, and it appears this corelates well with their shift to the right politically. I think this is becauise they have many physicians who do not support them, which allows the ideologues to rise to the top. I remember when the scientific comittee of the AMA recommended decriminalization of pot! Where is the MD outrage against poverty, war, or the increasing challenge to things like planned parenthood? MD's have become a self interested group and have forgotten their obligations to the public. It might surprise the AMA to find out how much we could accomplish together, if they could just get off their high horse and remember what we are here for.

Gus Geraci (9/26/2012 at 1:06 PM)
I don't see a suggestion of two classes of care, I see a highlighting of the fact that CRNP's (and PA's) are not as highly trained as physicians. Absolutely CRNP's and PA's should be allowed to practice to the top of their training, just as Family Physicians and Primary Care Internists and Pediatricisns should practice to the top of theirs. Primary Care Physicians should not have to see "routine" stuff. They should see the more difficult and complicated primary care problems, thus saving time for non primary care specialists to see the stuff they NEED to see, not the mildly difficult but the really difficult. It's time to stop throwing insults, and really work as a team. Let everyone work to the top of their licenses, and the entire system will benefit.