Primary care physicians move over, the
new American Association of Nurse Practitioners (AANP) is now united
(as of January 1, 2013) and looking to expand their role in
healthcare. As of this date, the American Academy of Nurse
Practitioners and the American College of Nurse Practitioners will be
the above AANP and have a combined membership of 41,000. The merger
will strengthen NPs' influence; the growth of the specialty has
already amplified its voice. NP numbers have risen nearly 80% in
just more than a decade, from 87,000 in 2001 to 155,000 in 2012, with
11,000 graduating from NP programs this year alone.
There are many reasons for the two
groups to merge, but the largest is the Patient Protection and
Affordable Care Act (ACA) which will mean about 30 million more
patients will enter the healthcare system through 2019. Then
according to a recent study in the Nov/Dec issue of Annals of
Family Medicine, the shortage of primary care physicians is
expected to exceed 52,000 by 2025. Then factor in the fact that the
medical groups are coming out in favor of limiting the functions of
NPs, makes it even more important that they present a united
position.
NPs have been doing the right thing and
working to present a consistent front in the establishment of
national guidelines for scope of practice. Currently this varies
from state to state. Some states require NPs to practice under the
supervision of doctors, and in other states, they can practice
independent of doctors. One objective that may be required under the
ACA rules is the ability to order home healthcare for patients.
Presently, to be reimbursed by Medicare, NPs can order home care only
through physicians.
There are many other areas that NP can
work in as well. I don't care the arguments raised by the American
Academy of Family Physicians (AAFP) and other professional medical
organizations, we are headed for a primary healthcare dilemma of
great seriousness and the professional medical organizations are
thumbing their noses at those that can help. If you are ready to
accept long delays in seeing your doctor and even longer delays
between appointments then support the physicians. Read my blog here
to understand that NPs are on a par with doctors and may actually
help reduce the cost of healthcare. Doctors are not really working
to reduce healthcare costs because they continue to order more and
more costly tests because they can.
Review this map for the states that are
welcoming NPs and those that doctors have presently under their
control. The map shows the states still allowing NPs to practice
very much like primary care physicians.
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