December 12, 2012

Nurse Practitioner Groups Unite

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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