Health reform can count on nurses

By Edward G. Rendell and Tine Hansen-Turton

One issue often overlooked in health care reform discussions is how the shortage of primary care physicians could undermine the quest for universal coverage.

The American Academy of Family Physicians estimates that residency programs need to graduate 3,700 to 4,100 family physicians per year to meet the growing need. But only 1,083 graduating U.S. medical students chose to enter family medicine in 2009. These numbers are part of a decade-long decline in interest in primary care among medical students.

So what's the solution?

In Pennsylvania, our reform plan advocates using highly skilled and licensed non-physician providers to help fill the physician shortage. More than 3,700 family nurse practitioners graduated from masters-level and postmasters-level programs in the USA in 2007. Nurse practitioners and other non-physician providers such as physician assistants, nurse midwives and dental hygienists can help stretch our resources.

Studies have shown that nurse practitioners are capable of managing 80%-90% of the care provided by primary care physicians without resorting to physician referral or consultation. And in all 50 states, nurse practitioners can prescribe medications. They also can diagnose and treat patients, order lab tests and refer patients to specialists.

Research has proved that these facilities provide safe, accessible and affordable care.

One of the state's — and nation's — biggest challenges is overuse of the emergency room. Patients often crowd ERs because they can't wait until their doctor's office is open for business.

How do we change this behavior? Open more retail-based clinics and health centers to ease the ER burden while reducing health care costs.

Effective reform requires innovation. One innovation is staring us in the face — certified, registered nurse practitioners who can help make the dream of health care a reality for all.

Edward G. Rendell is governor of Pennsylvania. Tine Hansen-Turton is CEO of National Nursing Centers Consortium.

Posted at 12:15 AM/ET, August 31, 2009 in Forum commentary, Health care/Insurance - Forum

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