NCPA - National Center for Policy Analysis

The Family Doctor, Minus the M.D.

October 29, 2012

To meet rising demands for health care, a new form of clinics has begun to emerge: clinics run by nurse practitioners, says the New York Times.

  • About 250 health clinics across America are now completely run by nurse practitioners.
  • These nurses require a master's degree that includes two or three years of advanced training in treating and diagnosing diseases.
  • A new proposal endorsed by the American Association of Colleges of Nursing for 2015 would require nurse practitioners to have a doctorate of nursing practice.

Many of these nurse practitioners are limited in what they can and can't do based on state law. In some states, nurse practitioners are completely free to treat patients and give prescriptions. However, some states won't allow these clinics without at least one trained physician.

These clinics staffed with nurse practitioners offer an avenue for alleviating some of the strain being put on primary care physicians. Indeed, the Affordable Care Act will bring 32 million uninsured people into the health system and there aren't enough primary care physicians to cover them. Furthermore, physicians are poorly distributed, many of them opting to work in urban areas rather than rural towns.

Some critics of having nurse practitioners run clinics argue that the quality of care is compromised for patients.

  • However, data has shown nurse practitioners provide good quality care.
  • One-hundred and eighteen published studies over 18 years found that nurse practitioner-led clinics were at the least equivalent, if not better, when compared to doctor-led clinics.

Moreover, nurse-led clinics are cheaper than traditional doctor-led practices. Furthermore, these clinics are small and don't need a variety of practitioners to keep the clinic at full capacity. Finally, nurse practitioner-led clinics provide patients with an alternative to the emergency room, which results in large savings.

Source: Tina Rosenberg, "The Family Doctor, Minus the M.D.," New York Times, October 24, 2012.


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