The nurse practitioner could make medical waves when patient demand à la health care reform meets a dwindling pool of primary care professionals.
The number of medical school graduates in primary care has been decreasing, said Joy Elwell, assistant professor of nursing and director of health services at Concordia College in Bronxville.
A nurse practitioner herself, she said “young graduates want to go into specialty and subspecialty practices because of their income-earning potential.”
The American Academy of Family Physicians reported the estimated shortage of primary care physicians could increase to 40,000 by the year 2020, according to Seth Gordon, president and CEO of the Nurse Practitioner Association of New York State.
“There”™s a tremendous need to service our health care population both currently and if you look at future needs, the population has grown by 100 million in the past 40 years and in the next 40 it will grow at a faster rate,” Gordon said. “There”™s a huge demand for the profession to fill roles in both nursing and medicine.”
There were more than 13,000 nurse practitioners licensed in the state of New York according to a January 2010 listing on the New York State Office of the Professions website.
Of that number, 863 are licensed to practice in Westchester County, with 326 in Rockland County and 90 in Putnam County.
“We provide primary and specialty health care and are licensed and authorized in 50 states to diagnose, treat and prescribe,” Elwell said. “We can have admitting privileges to hospitals (like she does at White Plains Hospital Center) and we perform checkups, we do urgent care and we care for acute and chronic illnesses.”
The work of the nurse practitioner is that of a “blended hybrid model” combining “nursing, medicine and other allied health sciences.”
It tends to ebb on the holistic, patient-centered side.
The nurse practitioner practices collaboratively with a physician, while the physician”™s assistant respectively works under their direct supervision, Gordon said.
Pending state legislation could dissolve the “written practice agreement” now required for nurse practitioners to work under The Patient and Advocacy Act.
Elwell said that although it is not a supervisory agreement, “if I lose my collaborative practice agreement, I have to stop working today.”
That could stem from factors as simple as retirement or a move out of state by the collaborating physician.
The physician could benefit too from time savings, she said.
“It would also reduce cost,” Elwell said. “For example, when I sign on with an insurance company, they have to check who your collaborator is and fax all that stuff in. Every year, with 14,000 (nurse practitioners) in New York and multiple insurance companies, it becomes a cost issue.”
