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Guidelines for the Nurse Practitioners and the General Practitioners
University of Cincinnati UCBA
Colleen Stanton
English 2089
Professor Benander
March 6, 2014
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Abstract
Practices of the General Practitioner and the Nurse Practitioner are changing due to the new
Affordable Care Act healthcare system .The change is also dealing with the cost of healthcare. Facing
each state is whether or not the Nurse Practitioners are ready for the challenge. This change in the
professional role of each is up for debate in the Senate of all the states in the USA, and other countries
in 2014. There are states that have changed the role of the Nurse Practitioner and others have not.
General Practitioners studies have been performed to compare care from General Practitioner and
Nurse Practitioners at home and abroad. Priorities that play a part in the legislative in 2013 were
debated by the American Association of Nurse Practitioners (Singer, 2013) .The issue is based on the
shortage of General Practitioners and to increase preventive and acute care that is given by the Nurse
Practitioner. Groups of physicians do oppose the change. The American Association of Nurse
Practitioners (Singer, 2013) provides the background debate and what is coming next in the Affordable
Care Act.
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States that allow and disallow Nurse Practitioner to extend their Profession
Some of the states that have allowed the Nurse Practitioners to expand their profession, are
Oregon, Alabama, and New Mexico. These states have enhanced the care given by the Nurse
Practitioner. They have allowed the There are other states that have followed suite. Nurse practitioners
have even moved their own practice to areas that allow them to care for their patients without the
supervision of a physician. They have a more profitable margin in order to provide better care for their
patients. With the extra income they are able to add equipment, supplies, and also staff for their
practice. Which in the long term will benefit the overall health of the community. It also allows them to
become fully responsible for their own action and performance they give the patients and community. It
allows them their independence and freedom to make their own decisions within the care of their
profession. It fills the need of the economy to increase Practitioners to fit the need of participants in the
healthcare system. Then there is a drawback of those who do not approve of the change. This is felt
from all aspects of professionals. It is going to be a long drawn out process to get everyone on board. It
is like anything else, not everyone will be happy with the outcome. There is also others that want to
know the thoughts and reasoning behind being a General Practitioner or a Nurse practitioner. Their
goals when it comes to becoming a General Practitioner or Nurse Practitioner is to provide the quality
care to the public and make a difference within society. They are very content with their practice and
content with their choice of the profession, in which they chosen. Most Practitioners spend an average
of time until they can retire and some beyond retirement.
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The changes that will evolve in the future will also affect the patient. The patients have to
accept the changes just as some of the professionals have since they have been implemented .Since
everyone is effected with the changes, the care of the world is up for debate in this day and time. How
we chose to embrace it, is up to each individual state and the Senate.
The counties of China, Germany, and Australia are also in the process of converting the Nurse
Practitioner role within their health care system. China, Germany, and Australia are looking at allowing
them to perform more for the patient. They explain the studies they have done, along with the results. It
is a project that seems to be undertaking in all countries around the world The USA is not alone in the
need to improve medical care and reduce the cost at the same time. Each country explains the cause,
effect, and the solution .Each county will also explain the solutions that they implemented in solving
the problem. Australia preformed a three state study involving, nurse practitioners in roles as an
independent, community health, epilepsy, and a community nurse. The results of these studies has
proven very powerful allowing for the appropriate legal framework and policy infrastructure to be
implemented, in order to succeed. Allowing April 25th 1998 for the field of nursing in Australia to be
one of the most memorable in the history of medicine. That was the day that Australians recognize and
implemented the title of nurse practitioner in New South Whales. The doors were opened and the
programs and Legislative was introduced. The Nurse Registration Board gave it the title The Nurse Act
(1991). If they were registered by the NSW they could use the title of Nurse Practitioner. Still unable to
prescribe drugs that are classified as addition drugs, but if they were registered by the NSW they could
us the title. This is only one example of what nurses have to endure to expand their profession abroad
or within the USA. The process that the nurse profession has to go through, along with the legislative
legal aspect is overwhelming to say the least. But they continue on, head held high, and proceed with
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pride on a journey that they feel strong about. Their only quest is to improve their profession to better
serve the public.
On the map below, you will find the list of states, and what they allow the General and Nurse
Practitioners to practices within their professions.
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Figure 1
The map demonstrates how the areas of South and West along with California tend to
limit the use of Nurse Practitioner as oppose to the Desert West and Northwest and as far more east
tend to embrace the use of the Nurse Practitioner.
Then there is a drawback of those who do not approve of the change. This is felt from all
aspects of professionals. It is going to be a long drawn out process to get everyone on board. There is
also others that want to know the thoughts and reasoning behind being a General Practitioner or a
Nurse practitioner. Their goals when it comes to becoming a General Practitioner is to provide the
quality care to the public and make a difference within society. They are very content with their
practice and content with their choice of the profession, in which they chose. Most Practitioner spend
an average of time to retire and some beyond retirement.
The changes that will evolve in the future will also affect the patient. The patients have accept
the changes just as some of the professionals have since they have been implemented .Since everyone
is effected with the changes, the care of the world is up for debate in this day and time. How we chose
to embrace it, is up to each individual state and the Senate. The way medical care is given is also
lacking a doctor s office. It could be a room within the pharmacy at Kroger’s, Walgreens, Myers or
CVS. These are places you can get food, clothing, health items, along with alcohol, just to name a few.
Now you can get healthcare also. Society today wants things now, not yesterday. Today’s generation
wants everything fast, accurate and precise. They are very knowledgeable of the care they need to
correct the illness in which they have. Patients today know more about their own bodies and how to
treat them. This is due to the changes within the medical field, public knowledge of technology, along
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with the media, and internet. You can also call a doctor on the phone or internet for a physical or get
diagnosed for treatment. The care of the world is up for debate in this day and time. How we chose to
embrace it, is up to each individual state and Senate.
Another crisis that faces the USA today is the lack of professionals that are going to college to
become a doctors or nurse. The numbers have decreased drastically to where we are short of both
professions. There are doctors that come to the United States to practice medicine. Along with them
they bring their knowledge and expertise. Once here, they find it hard to pass the testing system to
become a physician within the United States. They obtain employment within the field of medicine, but
not all in the profession as a doctor. In 2010 Physician Sajith Abeyawickrama, who came from Sri
Lanka, with the desire to practice medicine, instead he is teaching exam prep on genetics at Kaplan
Medical in Newark, N.J. He is among one of the doctors who has to teach rather than practice in the
field of medicine within the United States. Some would say it is the waste of an intelligent mind not
preforming medicine and doing what you were trained to do .Others could also say being in the medical
field teaching is just as rewarding. I guess it would dependent on which side of the spectrum you are
looking at how each one would perceive the side they were looking from.
Conclusion
In my research I was very impressed as to what duties the nurse practitioner preform without
recognition from their peers. Their job description is as follows. They conduct assessments, preforms
lab test along with evaluating results, diagnose the symptoms by sight and actual results of test. They
relay their finding to the General practitioner, so they can make the finial decision on all the facts from
the labs and assessment. This allows the General practitioner to finalize the diagnoses and prescribe
further testing or medication if needed. The Nurse Practitioner cannot do this on their own, only with
the general practitioners approval and signing off on the visit. According to some medical professionals
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and state legislatives, the nurse practitioner is not educated enough to perform the final steps of patient
care. They preform most of the vital part of being a care provider, like a General practitioner would do,
at the end of the visit the general practitioner gets all the recognition. They perform the same clinical
performance day in and day out. They work with the professionals in the field in which they have
chosen to work in. they have master the art of that medical field plus other vital information. If they
were not capable of preforming the art of medicine and providing patient care. The American Nursing
Practitioner would not have allowed them to become license. In order to get the license to perform as a
Nurse practitioner is very in-depth and you have to be knowledgeable of all parts of the medical field,
and in pharmacology. Test the nurse practitioner to see where they are as far as knowledge they have
when it comes to medicine and go from there. Compose a test that is similar to that of the General
Practitioner or Specialist, for the nurse practitioner to take. The American Medical Association does not
have to make things that are not complicated and make them so complicated. What they can do to
simplify things is educated the Nurse Practitioner in what they need to be educated in. Create a test to
challenge their knowledge. Once they take the test it will enable the American Medical Association to
see what they need educated in, and what they know.in order to practice in that area of medicine. This
allows the American Medical Association to see at what level of knowledge they have. At this point
they can be educated in the areas they need, not what they already know. By preforming these test it
will cut down on time and money. This will also impact the cost of healthcare in the long term. That is
what we are all reaching for , a more affordable healthcare cost, without effecting the care that is
given.To provide the care with the most knowlegeable professionals in the field of medicine.
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