Registered nurses picking up the slack in primary care

Nurse Leader Insider, September 29, 2016

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Last week, the New England Journal of Medicine (NEJM) reported that a series of statistics outlining the changing landscape of primary care. Workforce experts report there is a gap between population demand for primary care and the number of primary care physicians, and this trend is only going to grow. More and more, patients are replacing or supplementing primary care with nurse practitioners and registered nurses.

While we are well aware that nurse practitioners are capable replacements for physicians, the NEJM also suggests that RNs are also filling the shoes of primary care physicians. 43% of U.S. physicians worked with nurse care managers to treat patients with chronic conditions in 2015. These RNs follow physician-written protocols to help patients manage medication and encourage behavioral changes, lead care management teams that improve care and reduce patient costs, and coordinate care transitions to meet patients’ changing needs.

And unlike physicians, the number of graduating nurses is growing. Reports suggest that the pool of nurses will grow by 33% from 2012 to 2025, versus the physician pool that sees more physicians retiring than entering the profession over the same period.

However, there are still barriers for nurses to overcome in order to perform these roles. One such obstacle arises from the fact that many insurers do not cover RN services, though this is just beginning to change with some services, such as Medicare wellness visits and chronic care management meetings. Another such obstacle is the pay difference between primary care nurses and hospital nurses; in exchange for the steady hours and long-term patient relationships, primary care nurses make less than their hospital counterparts. But given the dearth of physicians, these factors will have to change in the next few years.

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