Daniel Lucky
Special to the Tribune-Star
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As a nurse practitioner (NP), I am left wondering who will care for the additional primary care needs for 30 million uninsured Americans with the passing of the Health Care Reform Law. Statistics regarding primary care physician resources are grim for sure. Many physicians are leaving primary care or choosing specialty careers out of medical school, instead of primary care for better pay. Additionally many physicians throughout the country are refusing Medicaid patients due to low reimbursement rates and the bureaucratic mess involving collection.
Now, the Health Care Reform law will add an additional 15 million lives to the Medicaid system.
Nurse practitioners remain the nation’s most underutilized resources that present a natural solution to our impending primary care disaster. NPs are registered nurses who possess advanced graduate-level education in physical assessment, diagnosing and prescribing medications for patients of all ages. Most NPs possess a master’s degree, yet by 2015 the standard for NP education will be the Doctor of Nursing Practice degree.
NPs differ significantly between physicians and physician assistants. NP practice is based on the nursing model of care — not the medical model. Nursing teaches us that we should not reduce human beings to mere signs and symptoms, place a disease label on someone, give them a pill and send them off. As nurses we are trained to look at the entire patient from a holistic perspective and then, actively partner with the patient and family to not only correct problems, but also enhance optimal health. Nursing care places the patient — not the provider — as the central focal point.
Established in 1965 by nursing pioneer Dr. Loretta Ford, the NP profession has grown significantly. NPs now have prescription privileges in all 50 states and are primary care providers for millions of Americans. Although NPs prescribe medication and perform minor surgery, health promotion, education and disease prevention are more than just buzz words for NPs — they are central forces that drive our practice.
Unfortunately, medical powers, such as the American Medical Association (AMA) lobby to block patients’ direct access to NP care. Unlike 23 other states that allow independent NP practice, Indiana law will not allow NPs to practice independently. Despite over 100 research studies supporting that NPs deliver excellent care and improve patients’ access to care, the AMA spend millions of dollars yearly to block legislation allowing NPs to practice without having a physician as a gatekeeper to NP practice. The medical establishments main argument is that NPs cannot deliver care safely — that is, unless the care we deliver is under the control of the physician.
The issue is simple: Patients’ access to care versus organized medicine’s power, control and profit. The solution: contact state legislators and support independent NP practice legislation. Inform legislators that patient access to care trumps organized medicine’s profits. Nursing is rated the most trusted profession for a reason. As in every war, crisis and calamity, nurses have the power to solve problems and effect positive outcomes, but only when we are afforded an opportunity.
Daniel Lucky is a nurse practitioner and serves as adjunct faculty for Indiana State University and adjunct nursing lecturer with University of Southern Indiana.
