Nurse Practitioners Push for an Expanded Role in Primary Care

Check out this interesting article about the push by nurses for an expanded role in primary care: http://www.bit.ly/dg7TSL. And check out this review of studies that compares advanced nursing care with physician-directed primary care: http://www.bit.ly/choFHP.

The nutshell? Advanced nursing care is often as good or better than care from a physician. And it costs less.

Although lower cost care is often equally as good or even better for the patient, there are few incentives in place to choose lower cost and lower intensity alternatives. People who are very sick may prefer to modify or even limit the intensity of the health care they receive. But everything in our system - and nearly everyone - points patients toward higher intensity.

This isn't exactly any one's fault. The whole system has us on a treadmill toward higher spending and higher-intensity care. Many insurers and health providers find themselves struggling to keep revenues high, which means the default choice is a physician over a nurse practitioner, a hospital over a community health center and a hi-tech over a low-tech intervention.

Just a little food for thought.