I honestly don’t understand why the American Medical Association(AMA) is so opposed to the role of nurse practitioners (NPs) as independent primary care providers. It is certainly not based in the research. I believe it is foolish and reckless.
I have tried to argue the merits and the research supporting NPs positive outcomes and cost saving in the primary care setting. It all falls on the AMA deaf ears, even when it is evidence based. One solution toted by the AMA, is training more primary care doctors. And how is that working out ? Have the numbers increased?
Nurse practitioners are needed and essential to the health of many people in this country. I know this because I lived it. I was lucky enough to have studied at the University of New Mexico(UNM) Nurse Practitioner Program. The mission of the school’s program was to train practitioners who would provide care for rural and under served communities. And they lived to the commitment.
I had just finished working five years in India as a nurse when I arrived at the University of New Mexico. I had seen diseases most of us in the USA only read about. I had epedemics of chicken pox, measles, typhoid fever and hepatitis to name a few. Medical back up was limited and available, only if a phone was working or a car could located. My favorite book was Where there is no Doctor, by David Werner. It became my bible because it described, in simple terms, each infectious disease process, treatment with fantastic illustrations.
During this time, I never thought of myself as a doctor but was forced to make medical decisions. When I left India, I knew I couldn’t go back to working as an RN. I thought of going to medical school but then I discovered nurse practitioners. I knew it would fulfill my dreams. I saw the role as a perfect fit and valuable asset of the healthcare system. I never even imagined parts of the medical community were so viciously opposed. So off to the UNM I went.
I was lucky to have been accepted at this school. New Mexico law allows nurse practitioners to have independent practice. Since most of New Mexico is rural towns or pueblos ( clinics run by the US Indian Health Service), NPs fill the gap providing care in these areas. I was able to do my clinical rotations in many remote clinics serviced only by NPs. Some clinics were owned by the NPs and others were branches of major health systems. All the clinics had relationships with medical groups and specialists from the closest city, who they could call with any questions. Specialists visited monthly. The communities were grateful to have any healthcare close.
My point is NPs matter to the healthcare system. They matter because there are not enough primary care doctors and NPs do a good job. The fear by the AMA is not based in the evidence or research. People don’t die more frequently at the hands of NPs. I learned while I was training, the incredible responsibility of diagnosing an illness. It is a sacred trust, one I never take lightly.
I say to the AMA, can you just stop this craziness about NPs and maybe focus on the real issues of healthcare? Can you take your head out of the sand?