NURSE PRACTITIONERS: Doctors Worry As Popularity Climbs
HMOs and consumers alike are increasingly turning to nurse practitioners to "deliver the routine checkups and treatments that doctors perform," the Oakland Tribune reports. "[W]hile nurse practitioners historically have cared for the indigent," today they are increasingly working in pediatrics, obstetrics and emergency rooms. In fact, nurse practitioners "have come to symbolize health care in the '90s" because they do the same work as doctors but for far less money. These health care providers, who study for two years longer than registered nurses, "are licensed to give physical exams and to treat common ailments, as well as chronic conditions such as asthma, diabetes or hypertension." Most work is done under the supervision of a physician. Kaiser Permanente employs 500 in Northern California hospitals and may add another 150 next year. Deloras Jones, director of divisional nursing for Kaiser in Northern California, said, "Because nurse practitioners are trained as nurses first, they have a holistic approach to health ... Nurse practitioners provide very high quality care, with a very high degree of patient satisfaction." In addition, the Tribune notes, nurse practitioners make "substantially less than doctors despite often doing the same work," which has added to their popularity.
Not Everyone Is Happy
However, the trend is "troubling" to the "powerful" California Medical Association, which has lobbied against expansion of nurse practitioners' duties. CMA member Dr. Rebecca Patchin said, "Patients we see in today's world are suffering from very complex problems, and we think a physician needs to be involved with those patients." However, the Tribune notes that "only three malpractice suits were filed against nurse practitioners" between 1994 and 1996. The "CMA has fought every possible bill and every possible piece of legislation to increase our scope of practice," said nurse practitioner Arlyss Anderson, who "suggested there may be some professional jealousy because her colleagues' personalized approach to patients is popular." Doctors, she said, are "very threatened" by the changes in their turf "carved out in the early 1900s" (de Sa, 5/26).