RNs can lighten the load for primary care physicians


A couple of years ago, Thomas Sinsky, M.D., a Dubuque, Iowa-based primary care internist was quickly approaching burnout. It was the sheer amount of work it required to manage his patients’ acute and chronic illnesses, while keeping up with e-mails, phone calls and faxes--not to mention prescription refills and quality measures.

What changed? Sinsky decided to work with his wife--who’s also an internist--and three registered nurses (RNs) in a team-based approach to care, according to a recent blog post by Diana Mason, Ph.D., R.N., for The JAMA Forum.

Today, the RNs on his team focus on preventive care, in addition to doing initial patient assessments. After gleaning this information from patients, RNs share insights with Sinsky and then provide follow up for treatment plans and coordinate care for the practice’s more complex patients.

With so many previously uninsured patients seeking out primary care providers, healthcare organizations have little choice but to take a hard look at how that care is delivered. Like Sinsky, one approach is to involve RNs in more patient care.

Patient engagement is a key part of RNs’ role as well: They’re also teaching patients about their health and providing counseling to help them better manage chronic conditions, writes Mason.

What’s Sinsky’s experience today? As he put it in a June 2016 presentation, “I love my work now. I’m able to actually see more patients and spend more time with them on issues that matter and require my expertise. I provide the medical decision making and the therapeutic plan and the [registered nurse] is the leader of the team when it comes to operationalizing the plan and managing the patients’ care,” according to the blog post.