On behalf of the American Academy of Nurse Practitioners (AANP), we read with interest the April 27 article: “Shortage of Doctors an Obstacle to Obama Goals” written by Robert Pear.  It addresses federal solutions to the primary care provider shortage looming in America. Among them is the greater use of nurse practitioners (NPs) in providing primary care services. We would like to reinforce that nurse practitioners are a significant solution to the problem you describe.

NPs are ideal health care providers for persons of all ages. For over 40 years, research has established that NPs provide high quality and cost effective health care, with excellent outcomes.  According to the February 2008, U.S. Government Accountability Office (GAO) Report: “Primary Care Professionals: Recent Supply, Trends, Projections and Valuation of Service,” NPs are the fastest growing discipline of primary care providers in the United States. In fact the number of primary care NPs is increasing at a rate of 9.44% per capita, compared to 1.17% per capita for physicians.

A number of recent reports in prestigious medical and health care publications provide evidence of excellent outcomes associated with NP practice, including JAMA (2000), Medical Care and Research ( 2004), Medical Decision Making ( 2006) , Cochrane Database of Systematic Reviews (2006), Medical Care ( 2004). Cost savings associated with NP practice; include lower rates of hospitalizations, lower laboratory utilization and fewer emergency room visits.

NPs are licensed independent practitioners who practice in ambulatory, acute and long term care settings as primary care providers. In addition to diagnosing and managing acute and chronic illnesses, NPs emphasize health promotion and disease prevention. They practice autonomously and in collaboration with other health care providers. Entry level preparation is at the graduate level.  The autonomous nature of the NP’s advanced clinical practice requires accountability for health care outcomes. Clearly, increased utilization of this health care professional would lead to better access, improved outcomes and overall lower health care costs.

NPs are well established as high quality health care providers.  There are over 125,000 of these clinicians practicing in the United States, the majority of whom are practicing in primary care. Approximately 6000 NPs graduate from their educational programs each year.   With proper funding this number could be increased substantially to assist in meeting the primary care needs of the public.  Better awareness of the value of NPs and increased access to their valuable services will go a long way in solving the primary care provider shortage. 

AANP, the oldest and largest national professional membership organization for NPs of all specialties, was created in 1985 to provide NPs with a unified way to network and to advocate for NP issues across all specialties at the local, state, and national levels.  Since its inception, AANP has continually served as a major resource for NPs, their patients and other healthcare consumers, to promote excellence in practice, education and research; to provide legislative leadership to advance health policy; to establish healthcare standards and to advocate for access to high-quality, cost-effective and personalized healthcare.

We appreciate having the opportunity to respond to your article and hope that you will assist in disseminating this information to the public as well.   AANP has extensive and comprehensive research data regarding NPs and their practice and we would welcome the opportunity to work with you as a resource in the future. 

Sincerely,

Dee Swanson, MSN, NP-C, FAANP , President

Tim Knettler, MBA , Chief Executive Officer

Jan Towers, PhD, NP-C, CRNP FNP, FAANP - Director of Health Policy