Respect & Nurse Practitioner Issues

During the late '50s and early '60s, medicine became increasingly specialized, resulting in large number of physicians leaving the primary care field. During this same period, Medicare and Medicaid began providing health care to the elderly and underprivileged, causing the demand for primary care physicians to increase. To fill this void, Loretta Ford and Dr. Henry Silver created the first nurse practitioner program in 1965. Since then, nurse practitioners have become a valued member of the medical community, but the field still faces several key issues.

Relationship with Physicians

• While many nurse practitioners enjoy a healthy working relationship with the physicians they work with, the relationship between the two professions is not always harmonious. Some physicians argue nurse practitioners receive mostly hands-on training that gives them experiential knowledge of most medical issues, but little understanding of the underlying principles. Nurse practitioners do not have to attend medical school, nor are they required to spend several years in residency before they can practice. This lack of intense study causes some doctors to feel uncomfortable trusting their patients to individuals they feel are less than qualified to make the proper diagnosis.

Shortage of Nurses

• Job postings nationwide for nurse positions throughout all medical fields grew 46 percent between May 2010 to May 2011, according to the research group Wanted Analytics. While the shortage of nurses continues to grow, the number of nurse practitioners doubled between 2005 to 2010, according to statistics compiled by the American Academy of Nurse Practitioners. The more registered nurses that become nurse practitioners, the greater the strain their departure creates on an already overworked and understaffed nurse corps in hospitals and long-term care centers.

Role in Primary Care

• In 2010, 28 states debated legislation that would allow nurse practitioners to run primary care facilities without a supervising doctor on hand. The American Medical Association lobbied against such legislation, arguing the critical importance of having a physician on hand to safeguard against any misdiagnosis by the attending nurse practitioner. Proponents of such legislation argued that nurse practitioners receive the necessary training to handle the types of cases normally encountered by primary care physicians and doctors are overqualified for a job that is more about coordinating care than determining a medical diagnosis.

Education

• To answer critics concerns about the level of education received by nurse practitioners, the American Association of Colleges of Nursing will require its 200 member schools to offer an Ph.D. program for students by 2015. Critics of nurse practitioner programs, however, argue that it is the type of training students receive that creates the largest obstacle to nurses providing primary care. Opponents claims nursing schools teach students to treat the comfort and care of the patient as their primary focus, while traditional medical schools teach about more the scientific aspects of disease and its affects on the body.