More than TLC
- More than 3 million American families annually have received care at some 1100 new retail clinics staffed primarily by advanced-practice registered nurses (APRNs).
- APRNs have facilitated the largest expansion of community health centers since the 1960s, with 7354 sites throughout the country now providing care for more than 16 million people.
- Nurse anesthetists administer an estimated 30 million anesthetics to patients each year.
Full article in The New England Journal of Medicine here.
My family and I have had great experiences over the years with treatment from nurse practioners at a nearby retail clinic. For weekend or evening flu, sinus infections or other non-ER “emergencies,” this is an option that’s saved us both money and hours of ER waiting time.
I don’t know their official policy, but in conversations I’ve had about the AMA, they seem to be opposed to anyone receiving medical care from anyone who isn’t an M.D. In that sense, the AMA looks more like a trade union rather than a professional association.
Numerous journal articles have found patients generally like the bedside manner of APRNs. Whether it’s real or imagined, NPRNs are perceived as listening better than doctors and spending more time with their patients than physicians. Some of this may be that (in the past) NPRNs tended to work for physicians and maybe didn’t have to worry as much about covering overhead. Or maybe during a time in the recent past when physicians are primarily male the (primarily female) NPRNs were perceived as having a maternal aspect to the care they provided. Whatever the reason, NPRNs are an important part of the continuum of care alongside MDs, DOs, PAs and nurses with less training.
Let’s hear it for nurses.
There isn’t much data on the relative costs of advanced practice nurses versus physicians. A study of NHS substitution suggests that the nurses see fewer patients per hour which means that, overall, they increased the cost of providing health care.
What do patients want? Planners don’t really seem to care. Yet another reason why we need markets in health care.