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Empowering NPs to Strengthen Physician Practices


A key resource for addressing physician shortages, improving efficiency in primary care and ultimately increasing access to health care for many more patients lies with the nurse practitioner role.

Today in the United States, the health care system faces a mounting shortage of general practitioners, rising costs of running a primary care practice and growing patient demand for health care services. This trifecta has created a conundrum for providers: how can physicians’ practices reduce costs without negatively impacting quality of care?

With an influx of 30 to 33 million newly-insured patients anticipated by 2016 as a result of Affordable Care Act legislation, according to an estimate from the Congressional Budget Office, health care demand and cost pressures are only anticipated to climb. A key resource for addressing physician shortages, improving efficiency in primary care and ultimately increasing access to health care for many more patients lies with the nurse practitioner role.

As a nurse practitioner myself, I am taking part in a positive shift in health care — a shift in which NPs are becoming empowered to provide patient care and specialized services more than ever before. Not only can this mean more access to care for patients, but an empowered NP staff can provide medical practices with desperately-needed flexibility and cost savings in a time of increased economic pressure.

NPs are well-equipped with sufficient medical education and training to function as primary and specialty care provider for many patients. Meanwhile, this role typically requires less compensation than a physician. Able to write prescriptions and diagnose many conditions while offering a flexible approach to treating the whole person, NPs make a valuable addition to many practices, even helping some to increase profit margins.

Additionally, as the NP role has become more empowered it has also begun expanding its reach. While the core responsibilities of NPs have remained similar for decades, the profession has started to navigate away from traditional primary care roles to a variety of other settings, including inpatient and retail medicine. A growing number of NPs, including myself, are also choosing to be more specialized in their work. One such example is NPs delivering allergy testing and immunotherapy directly to patients. This specialization helps to improve access to the therapy for more people and increases health care efficiency.

Immunotherapy is a specialty service that can benefit a far greater number of patients than have access to it currently. Unlike over the counter treatments which typically do little more than mask patients’ allergy symptoms, immunotherapy, also known as allergen-specific subcutaneous immunotherapy, is the only long-term relief from allergies and can even prevent the progression of the condition.

Yet the significant patient need for allergy care (allergies are one of the single most common chronic conditions in the U.S.) combined with the insufficient number of board-certified allergists to meet patient demand, creates a health care challenge.

As it stands, according to Centers for Medicare and Medicaid Services, only about 50% of patients who receive allergy shots are currently being treated by an allergist, due largely to the lack of supply. The balance is being treated by ENT and primary care physicians. More nurse practitioners providing allergy and asthma care could free up these physicians to focus on other areas of patient care, including acute allergy cases that require a specialized allergist.

An NP workforce that is skilled and empowered with the ability to deliver specialty services, such as immunotherapy, provides an opportunity to alleviate this gap and improve access for a majority of typical patients needing allergy care.

As a result of this opportunity, NPs are a welcomed asset in today’s health care landscape. Primary care has already been taking on more of the straightforward allergy cases and, with more nurse practitioners joining primary care offices, these practices have the opportunity to fulfill a common patient need. By increasing specialty service offerings, medical practices can not only boost patient satisfaction, but attract new patients and grow revenue opportunities.

As a career choice, it is a good time to be an NP. A key benefit of the NP role is the flexibility that it offers. We are able to pursue different specialties in health care, expanding our skills and experience in new ways and ultimately devoting our time to the most pressing patient needs and our own career interests.

The demand for NPs has always existed, but today it is growing. Not surprisingly, more of us entering the health care field are opting for careers as NPs — in fact, the number of NPs has been forecasted to double by 2025, according to a study in Medical Care. The health care system, including physicians, medical practice administrators and patients alike, stands to benefit from this growth with opportunities to improve the efficiency and accessibility of patient care.

The NP Guide: Essential Knowledge for Nurse Practitioner Practice

Dr. Kevin Letz specializes and practices in the field of allergy, asthma and immunology. He has practiced for more than 14 years in the field, both in private and academic practice. Dr. Letz is a doctorate prepared nurse and board certified as an adult, pediatric and family nurse practitioner. He has presented nationally for ACNP, AANP, CANP, ACAAI and NAPNAP and is an associate professor of nursing and owner of Allergy, Inc. Dr. Letz is also founder of The Society of Nurse Practitioners in Allergy, Asthma, & Immunology and recently published .

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