Since the days of Florence Nightingale, nurses and physicians have battled about issues of professional scope of practice. The recent New York Times opinion piece, Nurses Are Not Doctors, questions the role of nurse practitioners in meeting the growing need for primary care services in the US. I suggest that instead of arguing about professional status, it’s time to think about finding common ground.
Americans face growing needs for primary care but suffer a shortage of primary care physicians in many service areas. Americans are also worried about health care costs that threaten to overwhelm their household, industry and government budgets. The Institute of Medicine (IOM) report, The Future of Nursing, emphasizes the importance of nurses in redesigning our health care system. The IOM charges nurses to build strong ties with physicians to effectively transform health care services.
The Future of Nursing further emphasizes that the transformation of American health care requires teamwork among all health care providers. Nurses and physicians must join with pharmacists, social workers, physical therapists, hospital administrators and other health professionals to develop cost-effective, patient-centered models of care. One example is the Center of Excellence for Headache Care at Kaiser Permanente in San Diego, California. Neurologists, nurse practitioners, psychiatrists, physical therapists, pain specialists and other health professionals serve patients as a team. This model demonstrates improved patient outcomes and better management of health system resources.
Research articles and health care organizations across the country present more examples of collaborative partnerships between nurses, physicians and other health care professionals. These partnerships are on the increase because they improve access and quality while managing costs. Consumers and consumer groups support an expanded role for nurses, as evidenced by the AARP’s Future of Nursing Campaign for Action initiative. Teamwork is replacing turf wars in more and more settings, because transforming the US health system is imperative.
An innovation recommended in The Future of Nursing is to provide interprofessional clinical education to nurses, physicians and other health professionals. If students work together in their educational settings, they can develop skills in teamwork to apply throughout their careers. Schools of nursing and schools of medicine can lead the way by designing interdisciplinary educational programs for students of nursing, medicine, and other health care disciplines.
Americans can’t afford to wait for the primary care shortage to resolve itself. Higher wages that attract physicians to primary care may not materialize. We have a dedicated and highly qualified health care work force to draw on to meet the growing demands for primary care services and to help reduce physician shortages. Professional partnerships will improve access, enhance quality and reduce costs in our health care system. Turf wars will only impede progress.