NPs Should Not Lead Medical Homes, AAFP Says

[NRSKarenRN, BSN, RN]

Medscape Sept 2012 article:

NPs Should Not Lead Medical Homes, AAFP Says

...This is not the first time that organized medicine has taken a stand against NPs taking the helm of the medical home. In March 2011, the AAFP, the AOA, the AAP, and the American College of Physicians released model guidelines for accrediting medical homes that would prohibit NPs from being in charge. Of 4 organizations that accredit medical homes, only the Accreditation Association for Ambulatory Health Care limits the top spot to physicians.

The controversy over medical home leadership dovetails with the controversy over independent practice for NPs. According to the AAFP report, 22 states and Washington, DC, allow NPs to diagnose and treat disease on their own, although roughly half of them require that a physician supervise prescriptions. The AAFP opposes widening scope-of-practice regulations on NPs, arguing that these clinicians must not work apart from physician oversight..

NP Leader Says Profession Can Coordinate Care NPs who favor independent practice for their profession have heard all these arguments before, said Marsha Siegel, EdD, an NP in Cheyenne, Wyoming, and a past president of the American College of Nurse Practitioners.

Dr. Siegel told Medscape Medical News that a primary care NP is not a "full substitute" for a primary care physician, but nevertheless is qualified to direct a medical home. That role emphasizes coordinating care, which an NP can do, whether the patient needs a hand-off to a primary care physician or a specialist. That is already happening in NP-owned practices that employ physicians, she said.

She contested the argument that patient care slips when an NP supplies it. Studies going back to 1996, she said, document that "we have been providing quality of care equal to or better than that of primary care physicians."

[Corey Narry, MSN, RN, NP]

...whine, whine, whine. Yep, no surprise there. However, if only one of four accreditation entities does not allow NP's to lead Medical Homes, there's really no stopping NP's from actually leading Medical Homes in the 22 states where independent practice is allowed.

thanks for the article, NRSKarenRN

[Corey Narry, MSN, RN, NP]

Just for clarification about what a Medical Home is: The Medical Home Model of Care

[elkpark]

Well, what did anyone expect physicians to say? I agree, no big surprise.

[DNPpat]

A great panel discussion last week on this topic on Politico, featuring the President of AAFP and the President of American Association of Nurse Practitioners, as well as Donna Shalala and others.

Pro Health Care Breakfast Briefing: Defining the Scope of Practice - POLITICO.com