Could doctor shortage mean nurse practitioners see more patients?

Could doctor shortage mean nurse practitioners see more patients?


6 News Anchor/Reporter

KNOXVILLE (WATE) - There's a shortage of primary care doctors nationwide, and the problem is only expected to get worse. To solve it, 28 states are considering expanding the responsibilities of nurse practitioners.

Tennessee nurse practitioners already have more power than in many other states. For example, they can write prescriptions, but it must be under the observation of a doctor. Right now, there's no pending legislation to change that.

6 News spoke with the Dean of the College of Nursing at the University of Tennessee, Dr. Joan Creasia about this issue Wednesday. 

Dr. Creasia says while she can't predict the effects sweeping national healthcare reform will have on Tennessee doctor's offices, she believes full waiting rooms and nurse practitioners seeing more patients is likely.

Nurse practitioners must take advanced nursing courses. In addition to their normal four year bachelor's degree, they acquire about three more years of nursing education before becoming a nurse practitioner.

Many of them go on to get doctorates. It adds up to about seven years of higher education, but compare that to about 11 years for a primary care doctor.

Dr. Creasia admits that a doctor's scope of education is more broad, but she says for routine doctor visits and preventative care, nurse practitioners can provide an exceptional quality of care.

"The research has shown that there is very little difference between the type of care provided by nurse practitioners and physicians in the community, in primary care settings," says Dr. Creasia.

"Research has shown that nurse practitioners are at least as effective. They spend more time with the patients. The satisfaction of care is higher because they do spend the time and answer more questions than the physicians tend to," Dr Creasia adds.

"Now that's not to say physician care is not good, because it is, but for those kinds of things nurse practitioners can give exceptional care and do a great job," she explains.

Another problem the dean pointed out is that along with the growing shortage of family doctors, there's still a nursing shortage in Tennessee. 

Additionally, there aren't enough nursing schools or professors to educate those who want to become nurses. At UT-Knoxville, she says 150 to 200 potential nurses are turned away each year.

The state of Tennessee is trying to offer more incentives to get physicians to relocate. One example is forgiving loan debt based on the number of years a doctor will commit to practicing in areas of the state where he or she is needed.

The Tennessee Medical Associated just re-affirmed a resolution dealing with the rising cost of medical education and committing to look for ways to reduce costs or anything that's a barrier to attracting physicians.

6 News contacted officials with the American Medical Association who say allowing nurses to have more authority could cause more harm to the industry.

American Medical Association President J. James Rohack sent the following email response:

"With a shortage of both physicians and nurses in the U.S., increasing the responsibility of nurses is not the answer to the physician shortage. Physicians undertake a decade or more of postgraduate medical education and thousands of hours of clinical experience that provides them with the in-depth knowledge and ability to diagnose and treat patients. Many nurse practitioners have just three years of postgraduate education, limited prescription drug training, and clinical experience that is less than that obtained in the first year of a three year medical residency. If a health care professional with less than half of the education and training of a physician is given the same responsibilities, title and pay, there is no incentive to become a primary care physician. Each and every member of the health team plays a critical role, but we need to recognize the additional years of training and experience physicians undertake in order to maintain the high standard of medical care in the United States. We should focus our attention on increasing the number of health care professionals overall, physicians and nurses, so patients have access to the quality care they need."

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