Understanding the Role of Nurse Practitioners

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(Courtesy of The Chicago Tribune)

At a time when there’s a massive shortage of physicians throughout the country and wait times to get an appointment could take weeks, many people are turning to nurse practitioners to help with their medical problems.

But while nurse practitioners often act as substitutes for doctors, they can’t completely take over the physician role. We spoke with a nurse practitioner and a couple of physicians, who explained when to see a nurse practitioner and when to wait for a doctor.

Q: Should a person have any reservations about seeing nurse practitioners instead of doctors?

A: Usually, nurse practitioners work as a part of a team of medical care that also includes physicians, said Dr. Roland Goertz, president of the American Academy of Family Physicians. In this setting, medical care is transferred to the most appropriate person at a given time. “So if they suggest that you see a nurse practitioner and they’re operating as a team, then that works.”

Q: How are nurse practitioners trained?

A: They have a minimum of six years of higher education, said Angela Golden, a family nurse practitioner with a private practice in Arizona. First, they must complete a four-year bachelor’s program, and then they get a master’s degree in advanced practiced nursing. Like doctors, nurse practitioners also specialize. Some focus on adults, others on women’s health, neonatal care, family, or a number of other specialties.

Doctors, on the other hand, complete a four-year bachelor’s program, four years of med school and three to eight years of residency, depending on their specialty. General practitioners typically fall at the shorter end of the residency spectrum — usually closer to three years — while surgeons generally go for longer.

Q: Do nurse practitioners run every decision they make past a doctor?

A: Not everything. Some states even allow nurse practitioners to have a completely independent practice sans physicians. “In Arizona, I don’t have to have a supervising physician,” Golden said. “I collaborate and consult with other providers — pharmacologists, physicians and other nurse practitioners.”

Q: Should you keep seeing a nurse practitioner if it’s been a while since you’ve seen the doctor?

A: “If they are truly a well person who is simply having a routine exam, there’s no reason for them to see a doctor (instead of a nurse practitioner),” said Dr. Glen Stream, a family physician in Spokane, Wash., and president-elect of the American Academy of Family Physicians. “But a nurse practitioner’s practice is best conducted in a collaborative practice with a physician so if more complex problems arise, they can easily see a physician.”

Also, nurse practitioners can’t perform solo surgeries, so if you need surgery, you need to be referred to a surgeon.

140,000: Number of nurse practitioners practicing in the U.S., according to the American Academy of Nurse Practitioners. The average practitioner is a 48-year-old woman who’s been practicing for 12.8 years. Most see at least three patients an hour. Two percent of practitioners have ever been named in a malpractice suit.

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