Nurse practitioners are underutilized

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Karl Hawley, St. John’s
I think it was about 1 1/2 years ago I wrote to this paper about how nurse practitioners could modernize health care in this province.

Nothing happened. No small wonder — I mean, I’m only a layperson; how could I possibly know anything about health care?

Actually I know quite a lot, especially about what my many diseases have taught me. I am a Type 1 diabetic (for 32 years), a cancer survivor — six years ago I was given three years to live — and now, lucky me, I have a heart condition. So, I have pretty in-depth knowledge of what is and isn’t happening on the local front in health care and the delivery of services.

So I’ll raise the issue one more time, this time directed towards Health Minister Paul Davis, a former police officer, because the

former health minister, a teacher, didn’t seem to understand.

Cutting costs

Allowing nurse practitioners to practise independently in nurse practitioner-led clinics would lower the cost of health-care services and provide health services to “clients” or patients who do not have ease of access to general practitioners (GPs) or primary-care physicians (PCPs).

You know, it really is a no-brainer.

A team of economists led by economics professor Joanne Spetz from the University of California-San Francisco and professor Stephen T. Parente, director of the Medical Industry Leadership Institute at the University of Minnesota’s Carlson School of Management, wrote, “broadening the scope of practice laws for (nurse practitioners) could achieve savings in the costs of visits to clinics.’’

They report that nurse practitioners provide most of the care in such clinics that treat non-life-threatening conditions, clinics that can be found in pharmacies, big box stores and supermarkets.

The team compared the two-week costs associated with a clinic visit of 9,503 patients in 27 American States who visited retail and non-retail clinics at some point between 2004-2007.

Adjusted to 2013 dollars, the average two-week costs for a non-retail clinic visit (i.e. to a hospital) was $704. In states where nurse practitioners required physician supervision or collaboration, the cost of a visit was $543.

In states where nurse practitioners practice independently, the cost was $484.

Finally, in states where nurse practitioners both practised and prescribed independently, the cost was $509. So, if we project these cost savings into the not-too-distant future, it becomes quite obvious. Why don’t we do that here?

Many skills to offer

As I have said before, one cure for the growing shortage of PCPs and GPs is to broaden the scope of practice for these highly skilled professionals. Nurse practitioners can fill the void, as so many med students are choosing specialty fields of medicine, and who can blame them? Just follow the money.

As our population ages all across this province, it’s time we chose the right path, a path that provides quality of care for all our population, and we can do it at a lesser cost than we currently do.

It’s time we led rather than followed, isn’t it?

Karl Hawley, St. John’s

Organizations: University of California-San Francisco, Medical Industry Leadership Institute, University of Minnesota Carlson School of Management

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Recent comments

  • Linda W
    May 17, 2014 - 17:00

    Years ago I heard that using Nurse practitioners was the way to go and living in an outport community - I am all for the idea - as many are without family doctors anyway. This change is way overdue.

  • Stephen  Redgrave
    Stephen Redgrave
    May 17, 2014 - 07:33

    Since filing a formal complaint against her family doctor for failing to provide references and care--my wife switched to an incredible Nurse Practitioner , who now gives her the full attention and care she deserves. My personal opinion is that this nurse is 'light years' ahead of her "good old country doctor" , and 'up to speed' on just about every neurological, and biological problem a person could have. Nurse practitioners are the best idea, and service Newfoundland's health care could possibly provide--beef it up! and lets see more of these amazing men and women available in the near future.