Primary care physicians move over, thenew American Association of Nurse Practitioners (AANP) is now united(as of January 1, 2013) and looking to expand their role inhealthcare. As of this date, the American Academy of NursePractitioners and the American College of Nurse Practitioners will bethe above AANP and have a combined membership of 41,000. The mergerwill strengthen NPs' influence; the growth of the specialty hasalready amplified its voice. NP numbers have risen nearly 80% injust more than a decade, from 87,000 in 2001 to 155,000 in 2012, with11,000 graduating from NP programs this year alone.
There are many reasons for the twogroups to merge, but the largest is the Patient Protection andAffordable Care Act (ACA) which will mean about 30 million morepatients will enter the healthcare system through 2019. Thenaccording to a recent study in the Nov/Dec issue of Annals ofFamily Medicine, the shortage of primary care physicians isexpected to exceed 52,000 by 2025. Then factor in the fact that themedical groups are coming out in favor of limiting the functions ofNPs, makes it even more important that they present a unitedposition.
NPs have been doing the right thing andworking to present a consistent front in the establishment ofnational guidelines for scope of practice. Currently this variesfrom state to state. Some states require NPs to practice under thesupervision of doctors, and in other states, they can practiceindependent of doctors. One objective that may be required under theACA rules is the ability to order home healthcare for patients. Presently, to be reimbursed by Medicare, NPs can order home care onlythrough physicians.
There are many other areas that NP canwork in as well. I don't care the arguments raised by the AmericanAcademy of Family Physicians (AAFP) and other professional medicalorganizations, we are headed for a primary healthcare dilemma ofgreat seriousness and the professional medical organizations arethumbing their noses at those that can help. If you are ready toaccept long delays in seeing your doctor and even longer delaysbetween appointments then support the physicians. Read my blog hereto understand that NPs are on a par with doctors and may actuallyhelp reduce the cost of healthcare. Doctors are not really workingto reduce healthcare costs because they continue to order more andmore costly tests because they can.
Review this map for the states that arewelcoming NPs and those that doctors have presently under theircontrol. The map shows the states still allowing NPs to practicevery much like primary care physicians.
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