Docs and Nurse Practitioners Have Different Role Perceptions

Docs and Nurse Practitioners Have Different Role Perceptions

Research shows discrepancies in the way the role of nurse practitioners is viewed

WEDNESDAY, May 15 (HealthDay News) -- There is considerable disagreement between physicians and nurse practitioners regarding the role of nurse practitioners in primary care, according to research published in the May 16 issue of the New England Journal of Medicine.

Karen Donelan, Sc.D., from Massachusetts General Hospital in Boston, and colleagues surveyed 505 physicians and 467 nurse practitioners in primary care practice regarding the proposed expansion of the supply and scope of nurse practitioners. The researchers found that, compared with physicians, nurse practitioners were more likely to believe they should lead medical homes, be allowed hospital admitting privileges, and receive equal payment for the same clinical services. A total of 66.1 percent of physicians agreed and 75.3 percent of nurse practitioners disagreed with the statement that physicians provide a higher-quality examination and consultation than nurse practitioners.

Noting that the 2014 expansion of coverage mandated by the Affordable Care Act will result in a shortage of primary care physicians, John K. Iglehart, a national correspondent for the Journal, reviewed the risks and rewards of expanding of the role of advanced nurse practitioners. Iglehart discusses the state scope-of-practice laws that place limits on the clinical boundaries of advanced-practice registered nurses. These laws are supported by organized medicine, including the American Medical Association, and are opposed by nursing advocates.

"Unless physicians and nurse practitioners collaborate to improve primary care, neither will be happy with the outcome," write the authors of an accompanying editorial. "We urgently need a facilitated, open dialogue about the roles of physicians and nurse practitioners that includes representatives of the public."

Full Text - Donelan (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMsa1212938 )Full Text - Iglehart (http://www.nejm.org/doi/full/10.1056/NEJMhpr1301084 )Editorial (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMe1303343 )