There is a lot of confusion and misinformation about how the world of health care is changing around us. Today’s concern might be a website that does not work for enrollment, but tomorrow’s real issue is the lack of an adequate primary care workforce to meet the needs of the newly insured. Obama’s Affordable Care Act takes one major step to address it. The law makes a significant investment in nursing workforce development, specifically in nurse practitioners.
However, there is more that can be done. Educating and training more nurses is not enough. In order to build primary care capacity, we must invest in models of care that give nurses the opportunity to gain hands on experience delivering community-based care to the underserved.
The Association of American Medical Colleges projects the shortage of primary care physicians will grow to 65,800 by 2025. With over 30 million Americans poised to receive health coverage through the new law, the nation desperately needs to increase the number of primary care providers. To meet this need, the Institute of Medicine’s report on the future of nursing calls upon advanced practice nurses (such as nurse practitioners, nurse midwives, clinical nurse specialists) to fulfill and expand their potential as primary care providers across practice settings.
A large proportion of the newly insured will be in low-income families living in underserved communities. The nation’s 500 nurse-managed health clinics expand primary care access and relieve the burden on the nation’s physicians by utilizing advanced practice nurses and physician assistants to deliver cost effective, high-quality care to the underserved with little or no physician oversight.
In addition to primary care needs, nurse-managed health centers serve as vital “advocates” for millions of Americans as they navigate the Act’s new insurance mandates. When people have a place to go for regular care, such as nurse-managed health clinics, they use it and stay healthy and out of hospitals. We see those with diabetes who are able to control their condition, patients whose lives are saved by a simple medical test, and mothers who no longer have to choose between putting food on the table and getting their children immunized.
The best way to ensure that advanced practice nurses fulfill their potential as primary care providers and expand access for these patients is to invest in nurse-led care models. This kind of community-based care is already used in nurse–managed and school-based health centers. It can literally save lives.
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