Nurses and the Reinvention of Primary Care

The importance of nurses in cannot be underestimated as far as the
sustainability of the healthcare sector is concerned. Indeed, nurses
make up the single largest proportion of healthcare provider in the U.S,
not to mention that they make up the first contact point for the patient
in a large number of settings (Naylor & Kurtzman, 2010). They work in
varied healthcare settings usually taking the lead in management,
accountability and clinical roles pertaining to creative primary care
models. However, the primary care system in the United States has been
experiencing a myriad of problems including shortage in the workforce
that jeopardizes the provision of services. Indeed, there has been a
steady decline in the number of medical residents and students that
enter the primary care or pursue careers in family practice or general
internal medicine. Naylor & Kurtzman (2010) examined literature
pertaining to nurse practitioner’s participation in the healthcare
workforce so as to quantify and comprehend their roles in primary
healthcare. The research revealed that patient outcomes such as
satisfaction, social, emotional and physical functioning, and mortality
rates for those that see nurse practitioners were equivalent to that of
those who see physicians (Naylor & Kurtzman, 2010). Further research
showed that patients who see NP had higher levels of satisfaction,
longer consultations, more tests, with deficiency in appreciable
variations in processes of care, patient outcomes or resource us.
However, nurse practitioners face a number of barriers in their effort
to practice optimally. First, state laws limit the scope within which
the nurse practitioners can operate and prevent them from offering the
all-inclusive primary care services that their educational preparation
and licenses allow them to offer. In addition, nurses are under
disparate payment policies that ensure that their remuneration is lower
than that of physicians despite doing similar work. On the same note,
there exists professional tensions from varied healthcare professionals
for the control of the compensation and professional practice, which has
hindered efforts b nurses to be independent.
Nevertheless, the effectiveness of nurse practitioners can be enhanced
through removing unnecessary restrictions so as to allow for independent
practice that is devoid of regulatory requirements for supervision,
collaboration and direction (Naylor & Kurtzman, 2010). In addition,
payment structures should be reviewed so as to equalize their payments,
which should be complemented by holding nurses accountable for their
contribution to enhancing the value of primary care. On the same note,
nurse-managed centers should be increased and professional tensions
addressed through reinforcing inter-professional teams (Naylor &
Kurtzman, 2010). Lastly, it is imperative that pipeline expansions are
funded so as to increase the overall workforce in primary care.
While this article encompasses a lot of information, the fundamental
point revolves around irreplaceable nature of nurse practitioners in
enhancing primary care. Unfortunately, their optimal functioning is
usually hindered by institutional bottlenecks such as unequal payment
structures and professional tensions. While issues such as payment
structures have to be changed through policies, it is imperative that
all the professionals in the healthcare sector collaborate so as to
create a conducive work environment, as well as ease tensions between
the groups.
The information incorporated in this paper, therefore, would not only
be crucial to nurse practitioners themselves but also to the policy
makers especially with regard to payment structures. However, nurse
practitioners can use this information in determining the areas to which
they can expand their services such as the rural areas. On the same
note, it underlines the importance of respectful collaboration between
the varied healthcare professionals for the enhancement of the quality
of primary care.
Naylor, M.D & Kurtzman, E. T (2010). The Role of Nurse Practitioners in
Reinventing Primary Care. Health Affairs, 29, no.5:893-899

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