The New Generation of Providers

NPs: "There are plenty of patients for all providers"

These nurse practitioners see themselves and doctors as "interdependent," and stress that turf battles are counterproductive.

By Anita J. Slomski
Group Practice Editor

When nurse practitioner Carolyn Zaumeyer sold Women's Health Watch in Fort Lauderdale recently, she had over 4,000 female patients ranging from age 7 to 88. "I cared for business owners, waitresses, strippers, attorneys, and a doctor," says Zaumeyer, who is leaving her practice after seven years to run a company supplying blood products to pharmaceutical researchers. "The 7-year-old was on Medicaid, and the 88-year-old was a multimillionaire." Zaumeyer also marketed her practice to men who wanted confidential testing for HIV and sexually transmitted diseases.

Patients came to Zaumeyer despite the fact that she didn't take call, admit to the hospital, or accept insurance. Why did they put up with the inconvenience and expense? Zaumeyer rattles off the reasons: "My patients wanted a female provider; no one ever waited more than 15 minutes; the office had a casual, friendly atmosphere; and I charged half a physician's fee for an initial visit." Some physicians, she says, sent her patients regularly.

Entrepreneurial to the core, Zaumeyer lectured to NPs nationwide on setting up independent practices, and her book on the subject is assigned at some universities. "One physician in town was upset that I was encouraging NPs to venture out on their own. Then her NP bought my book and started her own practice," Zaumeyer laughs. She scoffs at physicians who view NPs as rivals, however. "There are plenty of patients for all providers," she says.

NP Donna Torrisi prefers to say that she and physicians are interdependent. It's her view that patients "get the best health care when there are multiple disciplines available to them. Physicians have to realize that they are not the captain of the ship, and that they should consult with nurses more often. The only way to meet the complex needs of patients is for providers to call upon each other and recognize our strengths and limitations. No one wins when we start fighting over territory."

Not that many physicians would covet Torrisi's turf. Abbottsford Family Practice, which employs five NPs, is in a public-housing community in Philadelphia. "No doctor would dare tell us to get out of here because they don't want the patients we serve," says Torrisi.

As a half-time clinician, Torrisi calls a physician regarding a patient problem only about once a month. The physician also visits the practice every six weeks to discuss patients the NPs have concerns about. And although the NPs take call, they refer to physicians any patients who have to be admitted to the hospital.

Although five primary care physicians have offices across the street from NP Melanie Arntz's practice in Burns, OR, she has no trouble filling her schedule with 25 to 30 patients a day. In fact, when an NP employed by one of those physicians departed, Arntz and her two NP colleagues gained some new patients who prefer to be treated by an NP. One appeal: "We schedule appropriately, so we can get patients in and out without a wait," says Arntz, a former president of the American Academy of Nurse Practitioners. Also, she and another NP in the practice were born in this rural town, which is 132 miles from the nearest medical center. "People have known us for years," she says.

Although Arntz's practice has no formal collaborative relationship with a physician, she doesn't hesitate to call one when she needs to. "Unlike many physicians," she says, "nurse practitioners are quicker to say, 'I don't know how to do this,' before they are in over their heads."

. NPs: "There are plenty of patients for all providers".

Medical Economics

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