[brian]

Nurse practitioners take on more responsibility, filling void of doctors in primary care

In a bustling medical office in this Philadelphia suburb, Marguerite Harris and her staff of eight provide prenatal care and child immunizations, write prescriptions and diagnose and treat ailments from diabetes to the sniffles.

Though it may sound like a typical doctor's office, it is not: No one on staff at Project Salud is a doctor. The medical center is run by nurse practitioners — registered nurses with specialized training and advanced degrees — whose numbers have risen from about 30,000 in 1990 to about 115,000 today.

Increasingly, patients are being treated by health care professionals with N.P. after their name instead of M.D. or D.O. Nurse-managed primary care centers such as Project Salud have increased in number to about 250 nationwide today, from a small handful 15 years ago.

"We've grown," said Harris, a nurse practitioner at Project Salud since 1974. "We've come a long way since the early days, the knockdown drag-outs with doctors who thought we were overstepping our roles."

The change is attributed to factors that include a drop in the number of doctors choosing primary care as their specialty, a falloff that is expected to continue.

From 1998 to 2005, medical school surveys showed, the percentage of third-year residents intending to pursue careers in general internal medicine dropped from 54 percent to 20 percent, according to the American College of Physicians. Many new doctors, saddled with high student loans, are choosing more lucrative specialties.

Full Story: The nurse is in [Pocono Record,PA]

[HARRN2b]

They have been discussing this on SDN. Many just do not want to spend so many years in school with such high student loans.

[nightingale]

Whenever I have been seen by a NP, instead of the Dr., more time was spent with me and I felt the overall assessment was more thorough.

[NRSKarenRN]

Philly is great area for nursing practice, especially NP's.


I've watched Philly's Nursing Centers grow starting with the Abbotsford Family Practice (first came to learn about in early 80's )started by Donna L Torrisi,RN, CRNP. Abbotsford Family practice reduced ER visits by 10,000/yr to local MCP hospital---now closed. They are one of the few health care providers remaining and flourishing in the East Falls section of Philly --now with second location.

Project Salud has spread it's mission and word in Chester County. My agency's Mother Baby RN's see some of their medicaid patients for postpartum newborn assessments. Very proud of Philadelphia 's nursing centers-- have referred pts and provided homecare to some of their members over the years.
See: Pennsylvania centers


More Info:

Nurse-Managed Health Centers are Changing the Face of Health Care

WHO ARE WE?

All across the country, there is a growing movement of committed nursing professionals who are bringing excellent health care to vulnerable communities. We treat sickness, but we promote health. We work with our patients to understand the issues and situations concurrent with their health problems. We offer nutrition counseling. We develop programs to address violence in the community and the family. We offer counseling and other supportive services. And we offer pre- and post-natal care that assures that healthy mothers will deliver healthy babies who will grow into healthy children. This is our movement and while it is still young, it has already proven to be a remarkably effective means of providing people with accessible, affordable, high quality health care.

Nurse-Managed Health Centers are run by nurses. Many have advanced practice degrees and are nurse practitioners, clinical nurse specialists, nurse midwives, and public health nurses. We have the expertise to diagnose illness and prescribe medication, to make referrals to specialists, to provide pre-and post-natal care, and to offer a wide variety of other primary health care services.

Our centers are focused on the needs of communities. We develop programs that meet the needs of our communities. We work with other health professionals to make sure that our patients get all the services they need. We bring people together to solve problems. We are located in public housing, and on blighted urban streets; on Native American reservations, and in rural communities; in senior citizen centers and in elementary schools; in storefronts and in churches. Wherever there is a need, we make health care work!

Video: National Nursing Center Consortium


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It is because of these centers pionerring role, high practice standards and excellent holistic patient care and community acceptance, that you see big business considering developing clinics in national retailers as for-profit venture.