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End-of-Life Choices

Trends in end-of-life care show that not only does the care given vary widely from region to region and hospital to hospital, but also patients often don't get the care they prefer. What can be done?

Care Management Puzzle

Chronic diseases and the cost of care are rising. Are disease management programs improving outcomes for patients with complex, chronic conditions?

No Middleman

Under the "direct primary care" model, patients pay a monthly fee for basic medical services. Learn about the history and current landscape of physician practices offering this arrangement.

Doctors and Nurses

Thursday, December 02, 2010

Nurse Practitioners Eyed for Addressing Health Care Gaps

Although 24 states allow nurse practitioners to practice independently, California requires nurse practitioners to work under a physicians' supervision. Some experts say California might adjust its nurse practitioner regulations because the federal health reform law is expected to expand health care access to millions of uninsured residents and put significant pressure on the state's health care system.

Reader Comments:
  • 1
  • 12/08/2010
  • Robert Forster

Only in a few states is it required to have a collaborating physician on the premises with a RNP (nurse practioner). Most states require a collaborating physician legally linked with a RNP (can be seeing patients independently)but must be available at least telephonically for collaboration or consultation or referral.
However, graduating RNP's are seeking more often specialty areas (cardiology, anesthesia, plastic surgery) than primary care specialties, hence new RNP graduates can only partially assist in the current deficit of primary care physicians. Ultimately, if we wish to support this PCP model, more PCPs will have to be graduated and the existing barriers must be dealt with holistically. RNPs have additionally been working independently for 40 years (e.g., rural health centers), the scope issue is pure politics and greed. Rob MD



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