Do Nurse Practitioners Hold Key To Health Care Reform Success?

The American healthcare system is already suffering from a shortage of primary care providers. According to the Association of American Medical Colleges, 2025 will be marked by a shortage of over 45,000 primary care doctors.

The new health care law is expected to bring in millions of new patients in the next few years, but there's already a shortage of primary care doctors in many parts of the country and adding more patients is only going to make things worse.

Conservative estimates by the University of Missouri and the federal Health Resources and Services Administration suggest that the new health bill will increase the workload of existing primary care physicians by 29 percent between now and the next 15 years. By the same period, the supply of primary care physicians will rise by only 7 percent, leading to a shortfall of 35,000 to 44,000 primary care physicians who treat adults.

Enter the nurse practitioner. With advanced education and intensive clinical experience, the modern nurse practitioner is performing services that were handled in decades past by physicians. And as the case load increases, the role of the nurse practitioner will continue to expand.

"Nurse practitioners are going to be the queens of the healthcare system," says Susan Ouellette, CRNP, CSP, APRN-PMH. "They're going to be the diamonds."

Nurse practitioners provide care for a variety of common health issues, including doing routine physical exams, treating minor illnesses, and managing diabetes. They perform medical acts of diagnosis, treatment, and prescription. "We have so many skills and we can do so many things," says Sue Ouellette, a Nurse Practitioner, health care educator, and professional speaker whose colorful track record includes speaking professionally throughout the US and Canada, developing diabetes education programs on a national level, and providing psychiatric care in various healthcare facilities (Sue Ouellette Speaks). As Ouellette points out, because nurse practitioners have a strong skillset and are highly trained, they are an obvious solution to the shortage of primary care doctors.

However, the American Medical Association (AMA) has openly questioned the adequacy of nurse practitioners to practice primary care. "I think the AMA doesn't really like nurse practitioners because they're threatened by nurse practitioners," says Ouellette. "Well, we're not trying to take over anything. We have a different skillset. We can do a lot of the same things that physicians can do, but some things we refer to physicians because they should be done by physicians, or it's the policy that its done by physicians."

Even if there were enough doctors to handle the number of primary care patients, many institutions would still turn to nurse practitioners. One reason is the reduced cost to patients and insurance providers. Nurse practitioners charge much less than doctors, with average salaries ranging between 85k - 120k per year. While the comparative affordability means that nurse practitioners are always in high demand, Ouellette points out that the salaries often fall short of fair compensation, considering how much the nurse practitioner role has expanded in recent years. "I think part of the reason is that nurse practitioners have, number one, not recognized their worth, and number two, not known how to organize and create better salaries."

A second reason for the popularity of nurse practitioners lies in the difference between the nursing model of healthcare and the medical model. Patients often say they prefer the style of treatment they receive from a nurse practitioner. "People like coming to nurses," says Ouellette. "We worked hard to care about the person, not just the leg. We were taught that the person's name was Bob, not 'the person in 405.'"

What does the future hold? Well, one of the side effects of providing 32 million additional Americans with health insurance is that many of these people are going to actually want to use it. Since there aren't enough primary care physicians to see all those additional patients we're going to have to increase the number of Nurse Practitioners. For those who are considering becoming nurse practitioners, now is the time to "get in on the ground floor," Ouellette declares. "I think nurse practitioners are poised to be major players in the new health care system."

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