Doctor vs. Nurse: Who will be the frontline in primary care?

It seems obvious even today, that in the future, the frontline in primary care will not be held by primary care physicians alone.

Why is this so hard to believe?

With 10,000 boomers turning 65 every day for the next 19 years (according toPew Research Center), the demand on healthcare providers will surely increase to unprecedented levels.

MDs entering primary care have decreased significantly and most experts predict that the number will continue to drop as most new graduates continue on to specialties.

Having been accepted to a medical program myself, the major reason I decided not to go was because in the future, physicians will only be specialists and nurses will coordinate the care of the patient. Why spend 200,000 dollars and 7 years on an education that I could get in an advanced practice program for nurses?

The Institute of Medicine (IOM) recently released a controversial article stating that nurses should fill the gap and step up as primary care providers. They urge systems to cut red tape and  bureaucratic hurtles to essentially increase the nurse’s scope of practice.

Not surprisingly, there is heavy debate in the internet world regarding what nurses are capable of doing as primary care providers.

Physicians are upset because nurses are treading on their territory. Nurses are upset at the lack of trust from physicians. Medical students are upset because they can’t go into primary care.

This debate needs to stop being an “us” vs. “them” conversation.

Instead, we need to come up with an innovative approach to meet the coming demands in primary care. This plan should include not only nurses and physicians on the frontline, but pharmacists and technicians as well.

Yesterday’s primary care model will likely drown with the coming tsunami of aging boomers and newly insured. Can we stop fighting long enough to create a care system that will endure?

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