In a recent article on Medscape, registered nurse Troy Brown explored the notion that states should allow nurse practitioners (NPs) to assume an expanded role in primary care as one way to address the current shortage of primary care physicians.
This opened the door to lively and occasionally acrimonious debate about the proper roles of physicians, nurses, and physician assistants.
Quite a few respondents believed that giving NPs more responsibility would be a valuable step toward providing much-needed care to underserved communities.
One NP kicked things off:
[I have worked in a rural area] for almost 20 years. I have seen many physicians come and go soon after their loans are paid off! I have stayed. The care I provide to my patients increases access, reduces costly emergency room visits, and provides patients a choice of their provider type . . . I've been through hurricanes when the power has been lost [and still saw] patients. My clinic is not fancy but provides accessible cost-effective care in communities where patients save both time and money...The MD-led model does not work! Many patients in rural America have no MD. Instead, we need to embrace an "all hands on deck" approach.
Another nurse faced similar challenges:
Every day I see patients coming to the emergency room because either they cannot afford to see a
