How Do Nurse Practitioners Receive Primary Care?

There is a growing trend where physicians are choosing different specialties instead of choosing primary care, primarily due to the low reimbursement rate in primary care. According to Iglehart (2014),” the Association of American Medical Colleges (AAMC) still projects a shortage of 130,000 physicians by 2025, split almost equally between primary and specialty care” (para. 1). With this decline comes an answer, an increase in the number of nurse practitioners providing patient care, reported 154,00 in 2012 and growing every year (Iglehart, 2014). This increase in nurse practitioners’ helps fill that gap, allow greater health care access to the community, especially special populations. By gaining access to healthcare were a nurse practitioner is the provider not only with the special population have high quality affordable health care, a trusting long lasting relationship will develop. This relationship will break the barriers of; lack of trust, lack of health care education and discrimination. Nursing is a trusted profession that provides education and care that no other health care professional

According to Health Resources and Services Administration If the system for providing primary care in 2020 were to stay fundamentally the same as today, there will be an estimated shortage of 20,400 primary care physicians ("Projecting the Supply and Demand for Primary Care Practitioners Through 2020," n.d.). In addition this projection doesn’t include the decreasing number of people perusing the medical degree and the baby boomers retiring form this filed of science. In the hand we are experiencing a significant increase in NPs and PAs. Considering this projected shortage, which is actually a very frightening situation the increasing number of NPs and PAs, can effectively be integrated; we could reduce the number of physician shortage by over 69 percent in 2020.

Since the inception of the Nurse Practitioner (NP) role in the 1960s, NPs have thrived in the delivery of primary healthcare and nurse case management. Despite patient satisfaction with NPs ' style of care, nurses have been critical of NPs, while physicians have been threatened by NP encroachment on MD practice. Balancing assessment, diagnosis, and treatment with caring defines NPs ' success as primary care providers. Understand the role and Scope of Practice of NPs is sometimes difficult for some to understand. The purpose of this paper is to define the role and history of NP, compare and contrast licensure versus certifications, understand NP Scope Of Practice and Standards of Care, discuss how the State Practice Acts regulate FNP practice, discuss credentialing and privileging, and differentiate between legislative and regulatory processes.

There will be an increase in budget deficit in the short-term due and due to the increased demand for primary care visits, we might experience a shortage 12,500-31,000 physicians by 2025

The decline in hospital capacity was accompanied by a rise in staffing. Full-time equivalent personnel rose (Malagi & Kamath, 2016). Most of the additional personnel in hospitals are not focused on patient care but management or administration purposes. The American Hospital Association data shows that outpatient department visits have risen per 1,000 persons indicating that capacity for ambulatory services has risen overtime. Emergency departments have reduced with a larger percentage of closures being in rural areas. Compared to hospitals, physicians have continued to increase. Specialists have increased except for radiologists and general surgeons. There is, however, an uneven distribution of physicians between rural and urban areas. There is an estimated shortage of 3,000 physicians in nonmetropolitan areas. In addition to an increase in physicians, there are new forms of acute-care facilities. There are relatively new facilities that have been accredited. Ambulatory surgery centers have, for instance, risen (Best et al.,

Nurse Practitioners have been providing primary care since the 1970S, but with recent changes in legislation, they are able to practice with a greater level of autonomy. This leads many to question whether ACNPs are able to meet the increasing

Economics and health were two independent subjects in high school, but nothing is truly independent in the real world. Supply and demand, one of the principals of economics, perfectly sums up the problem with primary health care. The supply of primary care physicians, also known as PCPs, is lacking by almost 52,000 providers to be able to fulfill the demand of the public within the next couple of years, and this isn’t a new issue (Petterson et al., 2012). Since the 1970’s there has been a shortage of PCPs, and it is becoming a bigger problem as the population grows and ages (Wilensky, 2014). The number of PCPs currently in the United States is not enough to meet the needs of the population. The view of primary care physicians and their salaries need to change in the U.S. to encourage more medical students to enter this much-needed field of practice. This paper will explore the reasons behind the shortage of PCPs and how the Affordable Care Act and the American Nurses Association are addressing this issue.

On an average, primary physician groups may see about four or five patients within an hour, probably about one patient every fifteen minutes. Because of increase productivity and cost restraints and pressures, this number could increase dramatically. This trend, unfortunately, will be matching the burden of physicians declining incomes and job market. A lessor number of physicians earn what physicians earned many years ago. Primary health has been affected more as compared to services rendered. Additionally, the shift to a bundled fee for performance from the fee for service reimbursement system for force solo practicing physicians and small group practices into forming or partnering into

The overall health care industry has undergone fundamental change over the last decade. Most of the changes have occurred within the underlying business operation of the healthcare industry. Legislation in particular has had a profound impact on the health care industry. First, due to the Affordable Care Act of 2010, the nursing profession is undergoing a fundamental shift in regards to the patient experience. The U.S. health care system is now shifting the focus from acute and specialty care to that of primary care which requires a shift in business operations. Also, due primarily to that aging of the baby boomer generation, the need for primary car overall is shifting and will be needed heavily in the future. The last 10 years in particular has seen an increasing influx of retiring baby boomers that subsequently need care. A positive impact on the ACA legislation is that more individuals are now insured. As such, the need for primary care will also increase over subsequent years, particular within the minority population. This patient centric approach will require more care predicated on specific communities in a seamless manner. Furthermore, primary care physicians will be in high demand over the coming years.

Primary care practice will be greatly impacted by health care reform. To provide better health care, the country will see a trend away from specialty to primary care and the avoidance of acute issues by delivering this care in the community setting. As a result, primary care physicians will be overwhelmed with the patient load as the number of the insured increases exponentially. The committee recognizes the scope of nursing practice that remains untapped and therefore the profession

Key message: “Nurses should practice to the full extent of their education and training. The IOM definition of primary care”. The provision of integrated accessible health care. Services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, practicing in the context of family and community”. (IOM 1998) The challenges mainly are management of chronic conditions, care co-ordination, prevention and wellness, prevention of adverse events ,provision of mental health services, school health services , long term and palliative care. Recommendation put forward by IOM to work collectively to improve through integration of primary care and public health. Advanced Practice Registered Nurses in 16 states and District of Colombia can diagnose and prescribe medications. These states have granted autonomy and significantly reduced the barriers to practicing independently, allowing patients greater access to quality care. The ARPNs work throughout from health promotion and disease

The role that nurse practitioner (NP) plays within the increasing complex health care system is a constant changing role with the Consensus Model and the introduction of the Affordable Care Act in 2010. The scope of the nurse practitioner (NP) includes the care of the young, the old, the sick and the well. The educational needs of a nurse practitioner vary greatly from that of a Registered Nurse (RN), in the amount of education as well as the focus of the education. NPs provide coordinated primary care with the use of comprehensive health histories and physical examinations, diagnosing and treating acute and chronic illnesses, the management of medications and therapies, ordering and interpreting tests results, and educating and

The advanced practice nurse embraces various roles to promote healthy lifestyles. The responsibility of this profession ventures beyond diagnosing and treating patients. The primary healthcare nurse practitioner (PHCNP) represents a “unique form of change agent for delivering services differently in a manner giving primacy to health and human complexity while delivering primary care medical services as a means of increasing and maintaining access”(Kooienga & Carryer, 2015, p. 806). APNs have emerged as advocates for their community and must rely on evidence-based practice to ensure that they provide quality service. Educating patients and integrating culturally competent care allows the APN to improve services to within the community. This paper will address the active role of the nurse practitioner as an advocate and teacher. It will also explore the impact of evidence-based practice and complementary therapies that are utilized by different cultures.

These impose severe constrictions on the ability of the nurse to move forward or advance into the areas of practice where traditional nursing practices were not allowed {Institute of Medicine, 2010}. However with the increase in the number of nurses graduating with advance degrees in nursing; the situation is changing. These well educated nurses are leading the charge to confront the complex issues that the rapidly changing health care situation presents. Regulatory barriers must be lifted so that nurses can practice within their scope in order to be reimbursed by private insurance for the services they provide. These changes can be done through the federal and state legislators as well as supervisory agencies and bodies such as congress and licensing regulatory boards. The IOM also recommends that nurses will expand their scope of practice and increase their responsibility through teaching and counseling of patients. {Institute of Medicine,2010}. The use of Advance Practice Registered Nurses and Physician Assistant in providing primary care services will decrease wait time and increase patient satisfaction. The high turnover of nurses transitioning from school to practice also affects the quality of care. These nurses do not have enough experience to make decisions in patient care.{Institute of Medicine,2010}.The IOM and JCAHO{2012} report supports the recommendations for the introduction of nursing residency

America spends more money on health care than any other nation in the world. It is surprising to note that despite the amount of money spent on health care, 16.7% of the total population in the nation still remains uninsured. According to World Health Organization reports, ‘America ranks 37 in health system’ (Gardner, 2010). A close look into the issue will reveal the fact that physicians in the US are getting a wage two times higher than those in Europe. In addition, the nation is facing acute shortage of doctors, thus compounding the problem. Probably as a result of these situations, there has been a growth in the number of retail clinics in the nation with the current number being above 1,000. As Kaissi and Zucker (2010)