Expanding the scope of practice for nurse practitioners and physicians’ assistants is seen as a way to make up for the decrease in primary care doctors. The Department of Veterans Affairs has taken the approach to allow for more timely access to care, for example—although there is a stark divide between how doctors and nurses feel about the move.
Rusk County Memorial Hospital, a 25-bed hospital in Ladysmith, Wisconsin, lost half of its primary care physicians and patient satisfaction and outcome rates were dropping, according to an article from Hospitals & Health Networks. So, it implemented a program that employs three nurse practitioners in rotating hospitalist shifts to take some of the burden off of the remaining primary care docs and emergency physicians.
The nurse practitioners work around-the-clock for seven days and then take two weeks off, according to the article. This allowed Rusk to recruit more nurses, as it did not require them to move to Ladysmith full-time. The nurses work alongside “collaborating physicians” and ED docs.
Overall, admissions have risen by 23% since 2014 and 85% of patients are now likely to recommend care from Rusk, according to the article, compared to 61% before the program. It's also been a financial win for the once-struggling hospital.
“Without the creation of our hospital medicine program, it is unlikely our hospital could have survived,” Rusk CEO Charisse Oland told the publication.