Tuesday, September 18, 2012

AAFP: Nurse Practitioners Not the Answer to Physician Shortage

The nation’s primary care shortage is expected to worsen as more American’s acquire health insurance and become eligible for Medicare. But a report released today by the American Association of Family Practitioners (AAFP), “Primary Care for the 21st Century,” cautions against substituting nurse practitioners for doctors to alleviate this shortage.

“Wholesale substitution of non-physician health care providers for physicians is not the solution, especially at a time when primary care practices are being called upon to take on more complex care,” said Roland Goertz, MD, MBA, chair of the AAFP Board of Directors and Texas Medical Association (TMA) member. Nurse practitioners do not have the same education or clinical experience as a physician, he says. “Their levels of knowledge and skills are complementary, but they are not equivalent.”

Instead, the AAFP says the most effective care is provided by a primary care physician or a team of health care professionals led by a physician in a patient-centered medical home (PCMH). A PCMH ensures that patient care is accessible, coordinated, comprehensive, and culturally relevant. The physician or team directly provides, coordinates, or arranges health care or social support services as indicated by the patient’s individual medical needs and the best available medical evidence. The model uses a team-based approach with the patient’s primary care physician leading the overall coordination of care. Trained teams and well-constructed electronic health records are key to a successful PCMH

“Patients need access to every member of their health care team — starting with a primary care physician, nurse practitioners, physician assistants, and all the other professionals who provide health care. Creating a system in which some patients have access to only a nurse practitioner is endorsing two-tiered care. That doesn’t happen in the physician-led patient-centered medical home, and we believe all Americans should have access to this quality of care,” said Dr. Goertz.

TMA’s legislative roadmap, “Healthy Vision 2020: Caring for Patients in a Time of Change,” outlines how PCMH could help to reduce fragmented care, lower costs, avoid repetitive and costly procedures, and improve patient outcomes. Given the budget constraints that Texas faces and a growing population with unique health care needs, the PCMH offers the potential for Medicaid cost savings as well as improved patient outcomes and physician and provider satisfaction.

View the infographic below for more information.

(Click for larger image)

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