Florida Association of Nurse Practitioners

Midwives and nurses are as good as docs -- and sometimes better, WHO finds

noreply@blogger.com (Fl ARNP) — Fri, 01 Nov 2013 01:14:00 +0000

Maggie Fox, NBC News

Midwives, nurse practitioners, physician assistants and other non-doctors do as good a job as MDs in the care they deliver — and patients often like them better, a World Health Organization team reported on Thursday.

These non-physicians are especially effective in delivering babies, taking care of people infected with the AIDS virus, and helping people care for chronic diseases such as diabetes and high blood pressure, the team reported in a WHO bulletin.

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The Nurse Practitioner Is In

noreply@blogger.com (Fl ARNP) — Thu, 31 Oct 2013 04:28:00 +0000

No, she’s not a doctor. She just does a lot of the same things doctors do.

By Archana Pyati

On a Tuesday morning in July, Dan Hellie woke up with excruciating lower back pain. The timing was terrible for the WRC-TV sports reporter and anchor since he was due in Richmond to cover the Washington Redskins training camp and the highly anticipated return of quarterback Robert Griffin III. Moreover, the next two days were to be Hellie’s last at the station and he didn’t want to call in sick.
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Medical Complaints Gather Dust in Florida

noreply@blogger.com (Fl ARNP) — Mon, 21 Oct 2013 12:27:00 +0000

By STEVE MILLER
FLORIDA CENTER FOR INVESTIGATIVE REPORTING

Medical professionals in Florida hang onto their licenses and continue practicing as the state grapples with a lengthy disciplinary process that can take years, according to an analysis by the Florida Center for Investigative Reporting.
Between 2010 and 2012, it took the Florida Board of Medicine an average 434 days to resolve charges of misconduct against doctors, physician assistants and anesthesiology assistants, according to Florida Department of Health records.

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Bonds Will Form With Health Teams, Not Docs, Experts Predict

noreply@blogger.com (Fl ARNP) — Wed, 16 Oct 2013 14:26:00 +0000

By David Pittman, Washington Correspondent, MedPage Today

Primary care providers need to accept that they won't have a traditional one-on-one relationship with all of their patients as the realities of healthcare force them to carry larger practices, health delivery experts said.

Instead, entire clinical practice teams must build and maintain relationships with patients as staff work more at the top of their license, said Thad Schilling, MD, medical director of the patient-centered medical home at Harvard Vanguard Medical Associates in Medford, Mass.
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The Dubious Case for Professional Licensing

noreply@blogger.com (Fl ARNP) — Sat, 12 Oct 2013 20:30:00 +0000

Uwe E. Reinhardt is an economics professor at Princeton. He has some financial interests in the health care field.

A recent brouhaha in California surrounding a bill introduced by State Senator Ed Hernandez, a Democrat, brings to mind Chapter 9, “Occupational Licensure,” of Milton Friedman’s classic book “Capitalism and Freedom,” published in 1962.

The original version of the bill, S.B. 491,would have allowed qualified nurse practitioners to offer a defined scope of primary care services in independent primary care practices, without supervision by a licensed physician. That is already permitted in 17 states. The politically powerful AARP had endorsed that version of S.B. 491, a free-market approach that Friedman would have enthusiastically endorsed as well.

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Nurse Practitioners Seek Independence Amid Growing Need for Primary Care

noreply@blogger.com (Fl ARNP) — Sat, 05 Oct 2013 04:31:00 +0000

By Lynn Graebner

Family nurse practitioner Myra Howard runs the Buellton Medical Center in Buellton, California. She’s also the majority shareholder in the clinic. But the law still requires that her practice is supervised by a physician.
“If my family practice physician decides to leave, I have to close my door and all my services and investment goes away,” Howard said. She and the five physicians she has hired serve an average of 30 patients a day ranging from celebrities to undocumented workers.
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Ahead of the curve: Making the move to PAs and NPs.

noreply@blogger.com (Fl ARNP) — Tue, 17 Sep 2013 13:32:00 +0000

By Michael J. Dill

AAMC’s Center for Workforce Studies recently published its study, “Survey Shows Consumers Open to a Greater Role for Physician Assistants and Nurse Practitioners” inHealth Affairs. With rapidly rising health care demand in the United States necessitating a greater reliance on physician assistants (PAs) and nurse practitioners (NPs), and rising concern over possible pending shortages of physicians, particularly in primary care, our study examined provider preferences from the patients’ perspective using data from the AAMC’s most recent consumer survey. Our findings indicate an openness on the part of US consumers to receiving care from PAs and NPs. This understanding can and should inform policy makers as they shape solutions to shortages, especially in primary care.

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In the battle for primary care, both doctors and nurses are to blame

noreply@blogger.com (Fl ARNP) — Sat, 14 Sep 2013 14:49:00 +0000

Kim Byars, ARNP | Policy | September 9, 2013

Apparently the Affordable Care Act has inspired panic among some physicians groups worthy of the fear historically reserved for deadly epidemics. From the articles I read, these groups are wringing their hands in hysteria over what to do and how to survive. One solution that has apparently gained popularity in these circles is the launching of campaigns against one of the most logical solutions, nurse practitioners.
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$1 million mistake: Becoming a doctor

noreply@blogger.com (Fl ARNP) — Fri, 13 Sep 2013 03:07:00 +0000

KATHY KRISTOF /

MONEYWATCH/ September 10, 2013, 12:53 PM

(MoneyWatch) If you are brilliant, ambitious and gifted in science, you may consider becoming a doctor. If so, think twice. According to a new survey by personal finance site NerdWallet, most doctors are dissatisfied with the job, and less than half would choose a career in medicine if they were able to do it all over again.

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Florida is No. 2 in the nation for rate of uninsured

noreply@blogger.com (Fl ARNP) — Fri, 30 Aug 2013 14:41:00 +0000

BY DANIEL CHANG

dchang@MiamiHerald.com

Florida has the nation’s second-highest rate of uninsured residents younger than 65 — a total of about 3.8 million people, or about 25 percent of the state’s population, including more than 500,000 younger than 19, according to U.S. Census data released Thursday. For more go here

Read more here: http://www.miamiherald.com/2013/08/29/3594606/florida-is-no-2-in-the-nation.html#storylink=cpy

Fox team welcomes new doctor, nurse practitioner

noreply@blogger.com (Fl ARNP) — Fri, 30 Aug 2013 14:28:00 +0000

By AMY GUCKEEN TOLSON Staff writer amy.tolson@theredstonerocket.com

They come from two distinctly different paths – one who vowed she would never be a nurse, another who always knew he wanted to be a doctor – but together, they are working to help Fox Army Health Center’s beneficiaries live a lifetime of wellness.
Go here for more

CBO: More NP Care Helped Slow Medicare Growth

noreply@blogger.com (Fl ARNP) — Wed, 28 Aug 2013 12:14:00 +0000

From AANP:

Increased use of nurse practitioners is likely to have contributed to slowing the growth in Medicare spending from 2000 to 2010, according to an August 22 Congressional Budget Office (CBO) report, although researchers said they were unable to quantify the impact of specific changes in health care delivery. The economy appears to have had little to do with slowing Medicare spending, but CBO had a hard time pinpointing the exact reasons for the historically low growth rate.
“We suspect that, over the decade, providers may have shifted toward methods of delivering care that resulted in slower growth in the volume, intensity, and cost of the care delivered.” the report states, citing the increased use of NPs and physician assistants, the decline in inpatient services, and the change in settings in which beneficiaries receive care near the end of life.

When Doctors Get Between You and Your Health Care

noreply@blogger.com (Fl ARNP) — Thu, 22 Aug 2013 02:01:00 +0000

By EMILY WASHINGTON. US news and world report

With pressure to find ways to slow the growth of health care costs, many states have granted nurse practitioners more autonomy in providing patient care. However, this type of commonsense reform can run into lobbying from special interests seeking to maintain a monopoly on service delivery, as lawmakers in California are finding out.
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ARE YOU SIGNED UP AS AN INSURANCE EXCHANGE PROVIDER?

noreply@blogger.com (Fl ARNP) — Thu, 15 Aug 2013 17:11:00 +0000

On October 1, 2013, uninsured patients will be able to start signing up for health care insurance in the newly formed Insurance Exchanges (Marketplaces) which will become effective January 1, 2014. This means that decisions currently are being made regarding which health plans will be qualified to provide insurance coverage for individuals applying for insurance through the exchanges (marketplace) in your state. Regardless of whether your state has chosen to utilize the federal program, develop its own program, or develop a shared program with the federal government, your state Insurance Commissioner’s Office will have oversight of the program. It is important to contact the Office of the Insurance Commissioner to be sure that you are among those providers that patients may choose as their health care provider in this program. If you have patients in your practice who are paying cash and hold no insurance, you need to check to be sure that you will be their provider under the policy that your patient will be expected to purchase. If you find that you are not considered to be an eligible provider, it will be important for you to challenge this decision (in light of the nondiscrimination statute in the Affordable Care Act (ACA)), and to communicate with us regarding your ineligibility so that we can inform HHS of this problem. In addition, all consumer questions and complaints are to be fielded by the state Department of Insurance. For further information, visit HealthCare.gov or marketplace.cms.gov. If you have further, questions feel free to contact AANP.

Nurse Practitioners Seek Right To Treat Patients on Their Own

noreply@blogger.com (Fl ARNP) — Thu, 15 Aug 2013 15:41:00 +0000

As posted tin The Wall Street Journal
By MELINDA BECK

Nurse practitioners in five states are fighting for the right to treat patients without oversight from doctors, as they can in many parts of the country.

The battle is particularly pitched in California, where a bill that would let some nurse practitioners do their work independently passed a key legislative committee this week. California doctors strenuously oppose the idea, arguing that it could jeopardize patient safety.

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Kevin MD Blog: Why Family Physicians are a Threat to Themselves (NICE POST ABOUT NPs/PAs)

noreply@blogger.com (Fl ARNP) — Sat, 10 Aug 2013 22:58:00 +0000

From clinical 1

Why family physicians are a threat to themselves
PAUL D. SIMMONS, MD | PHYSICIAN | AUGUST 8, 2013

In recent months, AAFP President Reid Blackwelder has been editorializing and debating what they see as the encroachment of nurse practitioners (NPs) and other “mid-level providers” (physicians are, presumably, “upper-level”) on the practice territory of family physicians (FPs). Dr. Blackwelder has repeatedly said that NP and physician roles are “not interchangeable.” The AAFP’s position on this issue seems to be resistance to the increasingly common decisions by state legislatures to free NPs of physician oversight. Dr. Blackwelder and the AAFP are misallocating their energies and resources – NPs are not a threat to family physicians. We are a threat to ourselves.

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Report: Nationwide Medicaid Expansion Would Boost Enrollment by 18.1M

noreply@blogger.com (Fl ARNP) — Thu, 08 Aug 2013 09:03:00 +0000

Written by Helen Adamopoulos | August 05, 2013 Medicaid and Children's Health Insurance Program enrollment would go up by about 37.4 percent if all states expanded their benefit programs under the Patient Protection and Affordable Care Act, rising from 48.3 million before the expansion to an estimated 66.4 million after full implementation,according to a Kaiser Family Foundation report.
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TWO BILLS YOU MUST SUPPORT TODAY.

noreply@blogger.com (Fl ARNP) — Wed, 31 Jul 2013 11:09:00 +0000

This is for the Home Healthcare Bill. So us PAs and NPs can order it. It is from the AAPA. If you are an NP change whatever you need and send on. On June 26, U.S. Reps. Greg Walden, R-Ore., and Allyson Schwartz, D-Pa., introduced HR 2504, the Home Health Care Planning Improvement Act of 2013. The legislation would allow PAs, NPs and clinical nurse specialists to order home health services for Medicare beneficiaries. http://www.capwiz.com/aapa/issues/alert/?alertid=62749786&PROCESS=Take+Action .

NPs valuable in care of chronic geriatric conditions

noreply@blogger.com (Fl ARNP) — Fri, 28 Jun 2013 17:06:00 +0000

News Wednesday June 26, 2013

NPs valuable in care of chronic geriatric conditions

A new study highlights the central role nurse practitioners can play in treating chronic geriatric conditions.

Researchers with the David Geffen School of Medicine at UCLA screened 1,084 patients at two primary care facilities in Southern California for four chronic geriatric conditions: falls, urinary incontinence, dementia/Alzheimer’s disease and depression. Of those patients, 658 had at least one condition; 485 of the 658 were randomly selected for medical review.

Of those 485 patients, 237 (49%) were seen by a nurse practitioner for co-management with a primary care physician of at least one condition. The rest were seen only by a primary care physician.

As reported in the June issue of the Journal of the American Geriatrics Society, the researchers examined whether a set of measures known as Assessing Care of Vulnerable Elders quality indicators were performed for each condition. For patients whose cases were co-managed by a nurse practitioner and a physician, the percentage of quality indicators that were satisfied was higher than for patients seen only by a physician.

For falls, 80% of quality indicators were satisfied for co-managed cases, compared with 34% for physicians alone; for urinary incontinence, 66% of indicators were satisfied, compared with 19%; for dementia, 59% were satisfied, compared with 38%; and for depression, 63% were satisfied, compared with 60%.

Much of the difference stemmed the fact that the nurses were likely to take far more detailed patient histories and to perform other assessments, according to the researchers. For instance, the pass rates — meaning whether the measure was performed — for taking a patient’s history of falls was 91% for co-managed cases, versus 47%; vision testing was 87%, versus 36%; and discussion of treatment options for urinary incontinence was 79%, versus 28%.

David B. Reuben, MD, the study’s lead author and chief of the geriatrics division in the Department of Medicine at the Geffen School of Medicine, noted that while physicians typically are adept at treating acute medical conditions and conditions requiring highly complex decision-making, they may overlook chronic conditions or not have the time to address them sufficiently.

The findings were limited by several facts, the researchers said. Some cases primary care physicians considered "mild" were not referred for co-management. Also, the study was conducted in only two facilities within a single geographic area, and consisted of a one-time intervention with minor revisions as the study went along rather than a longer, continuous learning process.

Read the study abstract: http://onlinelibrary.wiley.com/doi/10.1111/jgs.12268/abstract.

WE HAVE A HOME HEALTHCARE BILL IN THE HOUSE!

noreply@blogger.com (Fl ARNP) — Fri, 28 Jun 2013 16:36:00 +0000

From Clinician 1

SCHWARTZ, WALDEN FIGHT TO ENSURE HOME HEALTH CARE FOR SENIORS AND DISABLED

Jun 26, 2013 Issues: Health Care

FOR IMMEDIATE RELEASE
CONTACT: Greg Vadala 202-225-6111

Washington, D.C. – U.S. Reps. Allyson Y. Schwartz (D-PA) and Greg Walden (R-OR) introduced bipartisan legislation today to ensure that seniors and disabled citizens have timely access to home health services under Medicare.

The Home Health Care Planning Improvement Act will empower physician assistants (PA), nurse practitioners (NP), clinical nurse specialists and certified nurse midwives to order home health services for Medicare beneficiaries. Reps. Schwartz and Walden introduced the bill with 19 other House members signing on as cosponsors.

“We have a responsibility to provide America’s seniors with high quality, cost effective health care. A key part of that is ensuring they have timely access to health care services in the privacy, comfort and security of their own homes,” Congresswoman Schwartz said. “These highly-skilled health care professionals play a central role in the delivery of primary care, particularly in medically underserved areas, and are crucial to coordinating team-based care.”

“This common-sense bill will reduce unnecessary and duplicative burdens on health care providers and patients in need of home health services,” Congressman Walden said. “Particularly in rural areas like central, southern, and eastern Oregon where physicians are scarce, nurse practitioners, physician assistants, clinical nurse specialists, and certified nurse-midwives play an increasingly important role in the delivery of primary health care services. Not only are they serving on the front lines of primary care, but also in many areas they are the only option readily available.”

Medicare currently recognizes NPs and PAs as authorized providers who are able to order nursing home care for Medicare beneficiaries. However, they are unable to order less expensive and less intrusive home care services. Even in states that have explicitly expanded their laws to allow other medical providers to order home care, Medicare will still not certify payment for these services until a physician signs the order.

Those seniors and disabled citizens who see these medical professionals as their primary care providers often need an additional, unnecessary office visit with a physician in order to get the care they need. Congresswoman Schwartz’s legislation will eliminate that burden for our most vulnerable citizens.

If enacted, this legislation could produce significant savings for Medicare, with one study estimating that the plan would save more than $100 million over ten years.

“The Home Health Care Planning Improvement Act is good public policy. It offers improved access to and continuity of needed medical care for the many Medicare patients whose principal healthcare professional is a PA,” said Lawrence Herman, President of the American Academy of Physician Assistants.

“The American Academy of Physician Assistants is thrilled that Congresswoman Schwartz is introducing this bill. It would increase access to care and the continuity of needed medical care. We appreciate the fact that physician assistants are mentioned as active participants in this process. We’re also encouraged that face-to face contact by physician assistants is specifically mentioned in the bill,” said Bernard Stuetz, a Philadelphia-based physician assistant with the American Academy of Physician Assistants.

“Seniors and disabled citizens who see non-physician medical professionals as their primary care providers often need an extra visit with an unknown physician in order to get the care they need. This legislation will relieve that burden for our most vulnerable citizens,” said Carol Manchester, President of the National Association of Clinical Nurse Specialists.

The bill is supported by the American Nurses Association, National Association for Home Care and Hospice, the American Nurses Association, the American Academy of Physician Assistants, the American College of Nurse Practitioners, the American College of Nurse Midwives, the American Association of Nurse Practitioners, and the Visiting Nurse Associations of America.

Physician oversight hinders NP scope of practice

noreply@blogger.com (Fl ARNP) — Tue, 25 Jun 2013 01:55:00 +0000

Nicole Blazek

June 22, 2013

Las Vegas – Regulatory practices requiring unnecessary physician oversight for services that nurse practitioners (NPs) are educated, credentialed and competent to provide unfairly limit NP scope of practice and may jeopardize patient safety and health outcomes, according to a researcher at the American Association of Nurse Practitioners 2013 National Conference.
for more go here

The Latest Data On Primary Care Nurse Practitioners And Physicians: Can We Afford To Waste Our Workforce?

noreply@blogger.com (Fl ARNP) — Wed, 19 Jun 2013 14:30:00 +0000

June 18th, 2013

by Joanne Pohl, Debra Barksdale, and Kitty Werner

If primary care is the foundation of the evolving health care system in this country, and if access to primary care for all is the goal, then nurse practitioners will be increasingly crucial to achieving these aims. Let’s face it, in our current system, there just aren’t enough primary care providers to meet the nation’s need while containing costs and focusing on quality outcomes. With an estimated 30 million more people who will be covered and require access to full primary care based on the Patient Protection Affordable Care Act (ACA) numbers, we will need additional providers functioning to their fullest preparation.
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New York/New Jersey legislation could test APN 'tether'

noreply@blogger.com (Fl ARNP) — Tue, 04 Jun 2013 21:50:00 +0000

New York and New Jersey are among 15 U.S. states weighing legislation aimed at granting advanced practice nurses the ability to provide the full scope of nursing practice without physician oversight.

Nancy F. Muñoz, RN, MSN, New Jersey’s District 21 assemblywoman and the primary sponsor of one such bill, calls restrictions on nurse practitioners and other advanced practice nurses "an unnecessary tether."
For more go here

THC's Arley Long named National State Excellence awardee

noreply@blogger.com (Fl ARNP) — Tue, 21 May 2013 02:21:00 +0000

By Moneth Deposa
Reporter

A longtime nurse practitioner at the Tinian Health Center has been named a recipient of the prestigious National State Excellence Award.

Arley Long was chosen by the American Association of Nurse Practitioners to receive the honor for demonstrating commitment to her profession and for her valuable contributions to healthcare delivery

The association selects the recipients of its AANP State Awards for Excellence every year.

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The medical model versus the nursing model: A difference in philosophy

noreply@blogger.com (Fl ARNP) — Sat, 18 May 2013 01:06:00 +0000

SHIRIE LENG, MD | PHYSICIAN | MAY 13, 2013

I recently blogged about the question of what the difference is between a doctor and a nurse, now that advanced practice nurses can do so many of the same things physicians do. As both a nurse and a doctor I thought maybe I could wade into that quagmire. In that post I suggested that the real difference is one of ultimate responsibility. A reader pointed out that this is actually not true: in some states NPs and others practice independently. I also realized this statement of mine was a little insulting to nurses, somehow suggesting that they willingly abdicate responsibility for their patients. So I’ve thought about it and I have a new opinion.

For more go here