By Heather Beauparlant, DO, MBA, FAAFP, President of the Pennsylvania Academy of Family Physicians
Heather Beauparlant, DO, MBA, FAAFP
In the ever-evolving landscape of healthcare, two fundamental principles should always guide our decisions: do no harm and put patients’ interests first.
As a family physician, I have worked alongside skilled nurse practitioners (NPs) throughout my career, and I have the utmost respect for their dedication. They are a valuable part of the healthcare team, providing critical support to patients across Pennsylvania. Recent calls for expanding nurse practitioner independence, while well-intentioned, risk losing sight of what is best for patients and their long-term health.
Physicians and nurse practitioners are not interchangeable. It is not atypical for a medical school applicant to have 100-200 hours of hands-on and/or shadowing experience prior to starting medical school. I recently wrote a letter of recommendation for a student who has been working for two years as a medical assistant while completing his bachelor’s degree. The first two years of medical school are comprised of intense in-person didactic training, followed by 2 years of core and focused clinical rotations. Throughout medical school, students must pass board exams to demonstrate competency. Following graduation, physicians then complete three to seven years of postgraduate training (residency) with the potential for additional fellowship training. In contrast, nurse practitioners complete two to four years of graduate-level education, which is increasingly accomplished via virtual learning and teaching, with 500-720 hours of clinical training, and they do not complete a residency training program. This difference is not a criticism — it is a fact that highlights the depth of physician training to provide high quality patient care.
Research has consistently shown that patients place a high value on physician involvement in their care. According to a national survey, 95 percent of patients believe it is important for a physician to be involved in their diagnosis and treatment. When complex or high-stakes medical situations arise, having a physician at the helm is a critical component to achieving positive health outcomes.
Proponents of nurse practitioner independence argue that it will increase access to care, particularly in rural and underserved areas. The evidence from other states that have passed nurse practitioner independence shows that nurse practitioners and physicians tend to practice in the same areas, regardless of state scope-of-practice laws.
Patients living in these areas deserve the same high level of care as everyone else. In fact, the argument can be made that rural communities need the strongest family physicians because they lack a network of specialists nearby. Simply eliminating physician oversight is not a solution to a very serious problem. If the goal is to truly increase access to high-quality care, there are proven solutions that do not compromise patient safety. Expanding telehealth, increasing residency positions, offering loan forgiveness for physicians in underserved areas, and creating pathways for students from these communities to enter medical school are just a few examples. These initiatives can make a real difference without sacrificing the quality-of-care patients deserve.
Nurse practitioner independence may be well-meaning, but we must be careful not to pursue simple solutions to complex problems. Patients deserve more than that. They deserve a patient-focused healthcare team that works together with the highest standards of training, experience, and coordination. They deserve a physician-led team.
Editor/Publisher
Op/Ed: Putting patients first — the value of a physician-led health care team
By Heather Beauparlant, DO, MBA, FAAFP, President of the Pennsylvania Academy of Family Physicians
Heather Beauparlant, DO, MBA, FAAFP
In the ever-evolving landscape of healthcare, two fundamental principles should always guide our decisions: do no harm and put patients’ interests first.
As a family physician, I have worked alongside skilled nurse practitioners (NPs) throughout my career, and I have the utmost respect for their dedication. They are a valuable part of the healthcare team, providing critical support to patients across Pennsylvania. Recent calls for expanding nurse practitioner independence, while well-intentioned, risk losing sight of what is best for patients and their long-term health.
Physicians and nurse practitioners are not interchangeable. It is not atypical for a medical school applicant to have 100-200 hours of hands-on and/or shadowing experience prior to starting medical school. I recently wrote a letter of recommendation for a student who has been working for two years as a medical assistant while completing his bachelor’s degree. The first two years of medical school are comprised of intense in-person didactic training, followed by 2 years of core and focused clinical rotations. Throughout medical school, students must pass board exams to demonstrate competency. Following graduation, physicians then complete three to seven years of postgraduate training (residency) with the potential for additional fellowship training. In contrast, nurse practitioners complete two to four years of graduate-level education, which is increasingly accomplished via virtual learning and teaching, with 500-720 hours of clinical training, and they do not complete a residency training program. This difference is not a criticism — it is a fact that highlights the depth of physician training to provide high quality patient care.
Research has consistently shown that patients place a high value on physician involvement in their care. According to a national survey, 95 percent of patients believe it is important for a physician to be involved in their diagnosis and treatment. When complex or high-stakes medical situations arise, having a physician at the helm is a critical component to achieving positive health outcomes.
Proponents of nurse practitioner independence argue that it will increase access to care, particularly in rural and underserved areas. The evidence from other states that have passed nurse practitioner independence shows that nurse practitioners and physicians tend to practice in the same areas, regardless of state scope-of-practice laws.
Patients living in these areas deserve the same high level of care as everyone else. In fact, the argument can be made that rural communities need the strongest family physicians because they lack a network of specialists nearby. Simply eliminating physician oversight is not a solution to a very serious problem. If the goal is to truly increase access to high-quality care, there are proven solutions that do not compromise patient safety. Expanding telehealth, increasing residency positions, offering loan forgiveness for physicians in underserved areas, and creating pathways for students from these communities to enter medical school are just a few examples. These initiatives can make a real difference without sacrificing the quality-of-care patients deserve.
Nurse practitioner independence may be well-meaning, but we must be careful not to pursue simple solutions to complex problems. Patients deserve more than that. They deserve a patient-focused healthcare team that works together with the highest standards of training, experience, and coordination. They deserve a physician-led team.
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