“Patients ask me all the time why I don’t go back to
medical school and become a doctor,” Nurse Practitioner Janet Giangregorio said,
“I tell them, ‘If I went back to school to become a physician, I probably
wouldn’t be able to spend all this time with you.’”
Time is a major service nurse practitioners and physician’s
assistants, so-called mid-level providers, are bringing to the medical profession.
According to Walt Combs, M.D., Medical Director for Rancho Family Medical Group in
Temecula, that time is invaluable. “They have an expertise as educators. Dan
Ernst, our nurse practitioner, has an expertise in asthma and diabetes. He can really sit
down with a family and have the time to spend explaining the disease.”
With the authority to prescribe medication and serve their own
patient base, some people may be confused who their provider is. NP programs were first
developed in the mid-60’s, according to Giangregorio, to serve low-income and rural
populations where no physicians were available. Although NP programs have been around for
over twenty years, you may be encountering these professionals for the first time in your
medical group’s practice.
To become a nurse practitioner, education extends past a
registered nurse bachelor’s degree to a master’s degree, and follows a nursing
model. “Physician assistants practice under the medical model, with more focus in
line with what physician’s learn and practice,” Giangregorio explained.
“Nurse practitioners bring in more of the nursing model that has to do with caring
for the whole person and the family.
We get involved with more of the emotional/psychological aspects. As
a result, we end up taking care of patients with more complex problems like fibromyalgia
or depression. We work in collaboration with a physician. We accentuate their
practice.”
Dr. Combs said their mid-level providers work a lot with
preventative medicine. Also, by taking care of less complex problems, they take time
strain off a doctor, who often sees six to eight patients an hour. “I had
practically decided to close my practice to all new patients,” Dr. Combs said.
“It came down to closing the practice or getting help.
With a nurse practitioner I have been able to enlarge my practice
and the service we provide.” Again, it comes back to time. “I do more patient
counselling, I can be more of a patient advocate as far as getting them over the hurdles
with managed care,” Giangregorio said. Lorna Laney was one of the first nurse
practioners in the valley, and has practiced in several settings over the past 14 years.
Medicine has gone in an interesting way,” Laney said.
“It’s a collaborative practice and that’s what it should be. Doctors are
there to complement us if we need more expertise and we are there to complement them if a
patient needs more time or more education. Almost every family practice has a nurse
practitioner now, and almost every ob/gyn for that matter. We make a great team.”