Roles of nurse practitioners on the rise

In lowly populated rural areas that are increasingly bereft of doctors, nurse practitioners are stepping in to care for patients. Much of their work is primary care, ranging from treating patients with colds to daily maintenance of chronic diseases like diabetes. While under law of most states doctors must supervise nurse practitioners, in rural America these physicians often are miles away. As a result, the numbers of nurse practitioners have grown to 125,000, a spurt has occurred amid controversy.

"Nursing leaders say large numbers of [nurse] practitioners...will be needed to fill gaps in primary care left by an increasing shortage of doctors, a problem that would intensify if Congress extends health insurance to millions more Americans," Kaiser Health News reports. Supporters contend that nurse practitioners have the extra education and training necessary for many services like physical exams, diagnosis and care for common complaints and prescriptions for drugs.

On the other side, the American Medical Association and doctors' groups worry that patient care and safety could be compromised. For example, physicians in California are suing to force nurse anesthetists to be supervised, according to American Medical News. The AMA issued a report in October 2009 that was critical of the training nurse practitioners receive. A similar situation is taking place in Wisconsin.

Despite such opposition, nurse practitioners have found supporters. The Center for American Progress, a liberal think tank, said that the increasing use of the "entire health care workforce" would also "increase quality while decreasing costs" in a report last month. One of the Center's senior health policy analysts, Ellen-Marie Whelan added that nurses "should be part of managing chronic illnesses, helping a patient navigate the system, helping to coordinate among providers."

While qualifications for nurse practitioners can vary, in most states they have to earn a master's degree in nursing. For the patients in thinly populated areas without easy access to doctors, nurse practitioners are giving them the routine care they desperately need.

To learn more from about nurse practitioners:
- read the Kaiser Health News report