The nation is currently experiencing a shortage of primary care providers. As recently as 2008, less than 10% of graduating medical students chose careers in primary care, while 70% of NPs practice in the primary care setting. These numbers suggest that changes in the health care system are inevitable—and that in whatever system emerges from the current reform efforts, NPs will play a dominant role in improving Americans’ access to primary care.
One of the concepts being discussed is the medical home, which promotes whole-patient wellness and disease prevention by developing partnerships between patients and a team of health care providers. Since the inception of the NP role, we have followed this type of practice model. NPs are uniquely positioned to absorb the increasing demand for primary care, and AANP is actively promoting NPs as a natural choice to assume leadership of medical home teams.
The inclusion of NPs in medical home legislation is critical. This model strives to deliver coordinated primary care directed by a single health care provider. NPs are not a threat, as some of our medical colleagues believe. We too are trying to answer the challenge of keeping pace with the demands for quality health care for everyone.
CR: How would you rate the current level of recognition your profession has with the public? How can we increase public awareness of NPs?
Jensen: Public awareness has grown over the past five years due to the expansion of retail clinics, which have been a very successful venue to showcase NP practice. However, this has also affected the perception of some consumers, who feel NPs can only treat acute illness and work within a narrow scope of practice. This is simply not true.
In addition to diagnosing and managing acute episodic illnesses, NPs have been managing patients with chronic illness successfully for many years. A large body of research has established that NPs provide high-quality, cost-effective, comprehensive, personalized, patient-centered health care with excellent patient outcomes. NPs place a strong emphasis on health promotion and disease prevention, which is imperative to reduce the relentless increase in spending on medical care.
We are always trying to get the message out. Under the leadership of our new CEO, Tim Knettler, and the Board of Directors, AANP recently hired a public relations firm. In our 25 years we have never had a national PR firm represent our organization. The company, Weber Shandwick, launched a very successful campaign for the Susan G. Komen Foundation. As Dee Swanson often says, “Everybody knows what a pink ribbon means.” It is my hope that during my term, NPs’ visibility will improve dramatically.
The early results of the consumer surveys undertaken by our PR firm have confirmed a frustrating truth long known to NPs: 50% of those surveyed did not know that NPs can prescribe medications, diagnose, or treat patients without a supervising physician.
Confusion over the role of NPs has led to state laws and regulations governing our work. Although many of the barriers to independent practice have been removed, many still remain. While many states grant full independence to NPs, some still require NPs to work under the direct supervision of a physician.
On a daily basis, NPs have an opportunity to impact the public’s perception about NPs, our abilities, and those we serve. NPs are constantly challenged with countering misinformation or verifying the positive outcome data that are published, but unfortunately we spend a large amount of time correcting misleading or erroneous information reported by the media.
This year, National NP Week will take place from November 7 to 13. NPs in individual states are encouraged to request proclamations from their governors or mayors to improve NP visibility locally. AANP supplies the materials needed, including a resource guide, press release, and radio spots (PSAs) that we can give to local radio stations.
CR: How can we increase collaboration between NPs and PAs at all levels (national, state, individual practice setting)?
Jensen: As with all other health care providers, our patient population should be our utmost concern. We both have separate issues as related to licensure and supervision, but we do have many issues that we work closely together on.
I think it is critical to build coalitions with PAs for addressing areas of common concern: for example, access to affordable medications for our patient population and access to quality health care.
We share common concerns that affect our practice and ability to provide high-quality care for our patients. It is very important to recognize the value of our PA colleagues; on a daily basis, we often consult with one another and welcome the opportunity to work together on many issues, such as professional practice and health policy. NPs collaborate with health care providers at all levels and certainly work with PAs on those issues. Our training is different, but we work well together as part of the health care team.