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Primary care v. nurse practitioners and specialists

Posted Oct 30 2012 7:30pm

Brian Klepper comments on the American Academy of Family Physicians’ recent moves to knock down the idea that nurse practitioners are equivalent to physicians for primary care. He mainly concedes their point –after all family physicians have about quadruple the training of NPs– but he’s surprised that AAFP is training its sights on NPs rather than specialists.

In particular, he notes that while NPs are unlikely to take over a central role in primary care, specialists are already doing so. He has some theories for why this may be so:

  • Primary care is “demoralized and insecure” and therefore acting like a bully beating up the weaker nurses rather than the tougher specialists
  • Primary care’s leaders have “failed to compellingly convey primary care’s value” and “been meek in defining models that can drive efficiencies”
These are fair points. But there are others that deserve mention. In particular:


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