Physicians began mentoring nurses with clinical experience in the 1960s. At the time, many primary care physicians had left their practices (especially in rural areas) to pursue specialization. The remaining physicians weren’t able to meet the demands. And then when Medicare and Medicaid programs started to provide health care coverage to low-income patients in 1965, nurses “stepped into the breach.” And the nurse practitioner profession was born. Today there are more than 189,000 NPs practicing in the US. Most (69%) see three or more patients per hour. And almost all (97%) prescribe medications. They are accessible, they provide cost-effective care that is said by many to be equivalent to that provided by physicians, and malpractice rates are low; only 2% of NPs have been named as primary defendant in a case. So, why not give them more independence?
The country still faces a shortage of primary care physicians, and with millions of new patients who just signed up for Affordable Care, states like New York are passing legislature to allow NPs to provide primary care without physician oversight. (16 other states have done so already.) But some doctors including cardiologist Sandeep Jauhar claim that allowing NPs to work independently won’t save money and would result in lower quality care. His solution to filling the primary care provider gap is to attract more medical students to primary care with salaries that are competitive with those of medical specialists.