Please read the attached file (AAFP vs ANCP) and write a 1 page response in a form of a letter to the AAFP’s statement. Write the way as if you are writing back to the editor at AAFP about your view on this issue. Support your statements/claims with quotes from attachment/or scholarly articles on this topic.

Please read the attached file (AAFP vs ANCP) and write a 1 page response in a form of a letter to the AAFP’s statement.  Write the way as if you are writing back to the editor at AAFP about your view on this issue. Support your statements/claims with quotes from attachment/or scholarly articles on this topic.

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You may or may not have heard that the American Academy of Family Physicians recently came out with a strongly worded statement against independent NP practices.

 

AAFP Cautions Against Stop-Gap Efforts to Solve Primary Care Shortage

Physician-Led, Team-Based Care is Key to Better Outcomes, Access and Cost Savings

FOR IMMEDIATE RELEASE
Tuesday, September 18, 2012

Contact:
Leslie Champlin
American Academy of Family Physicians
(800) 274-2237, Ext. 5224
lchampli@aafp.org

LEAWOOD, Kan. — The U.S. health care system can meet the nation’s need for primary care providers by fully implementing physician-led patient-centered medical homes, according to a new report released today by the American Academy of Family Physicians. The report, “Primary Care for the 21st Century,” lays out the research that supports team-based care and its ability to transform primary care in the United States. It focuses on the need for this team-based approach to improve quality and cost efficiency in the American health care system.

In the report, the AAFP cautions against substituting nurse practitioners for physicians as a stop-gap answer to the primary care physician shortage. Such a solution flies in the face of multiple studies that demonstrate the best, most efficient care is provided by teams of health professionals in the patient-centered medical home led by physicians, not independent practice by a single health professional.

The PCMH model improves the quality of care because it capitalizes on the unique expertise of each member of the patient’s health care team, according to Roland Goertz, MD, MBA, chair of the AAFP Board of Directors. In doing so, it expands access to services while ensuring each patient is under the care of a physician. Research has demonstrated that teams of health professionals in the PCMH improve quality; reduce unnecessary tests, procedures and hospitalizations; and result in lower patient-care costs.

The report has garnered support from the American Academy of Pediatrics, the American Medical Association and the American Osteopathic Organization, which have joined the AAFP in advocating for the PCMH.

The answer lies in the team-based care that gives patients access to their primary care physician as well as their nurse practitioner, physician assistant or any other professional involved in their care, according to Goertz.

“Wholesale substitution of non-physician health care providers for physicians is not the solution, especially at a time when primary care practices are being called upon to take on more complex care,” he said. “Patients need access to every member of their health care team — starting with a primary care physician, nurse practitioners, physician assistants, and all the other professionals who provide health care. Creating a system in which some patients have access to only a nurse practitioner is endorsing two-tiered care. That doesn’t happen in the physician-led patient-centered medical home, and we believe all Americans should have access to this quality of care.”

Patients understand and care about the disparities in training. According to the American Medical Association, more than nine out of 10 respondents to a recent survey said a physician’s years of education and training are vital to the best patient care, especially in emergency and complicated situations. And three out of four patients said they prefer to be treated by a physician.

Education and training of physicians and advance practice registered nurses are substantially different, and physicians and nurses are not interchangeable, according to Goertz, who added, “Their levels of knowledge and skills are complementary, but they are not equivalent.”

The report notes that primary care physicians complete 21,700 hours of education and clinical training during 11 years, compared to nurse practitioners’ 5,350 hours of education and clinical training during five to seven years. All family physicians complete a four-year undergraduate degree and a four-year medical school program. They must pass two tests given by U.S. Medical Licensing Examinations to earn their medical degree before beginning their three-year primary care physician residency training. The result is a health professional who “brings breadth and depth to the diagnosis and treatment of all health problems, from strep throat to chronic obstructive pulmonary disease, from stress headaches to refractory multiple sclerosis,” the AAFP report says.

Although 11 states and the District of Columbia don’t require a master’s degree to be a nurse practitioner, most NPs are registered nurses who have completed their nursing education through a one-and-a-half- to three-year degree program that confers a Master of Science in Nursing degree. Their training gives them expertise in epidemiology and community health, as well as treating patients who require basic preventive care or treatment of straightforward acute illness or uncomplicated, previously diagnosed chronic conditions.

“Together, the physician and nurse practitioner comprise an extraordinary team of professionals whose expertise supports and complements each other in the patient-centered medical home,” said Goertz.

 

In response, the American Academy of Nurse Practitioners (ACNP) released this statement 9/24/2012:

 

 

Nurse Practitioners Disappointed with American Academy of Family Physicians Report

 

Alexandria, VA, September 24, 2012 – In response to the American Academy of Family Physician’s recent report entitled “Primary Care for the 21st Century: Ensuring a Quality, Physician-Led Team for Every Patient,” the American College of Nurse Practitioners President, Jill Olmstead, MSN, NPC-C, released the following statement.

 

The American College of Nurse Practitioners is disappointed that the American Academy of Family Physicians does not hold the same conviction as we do; that nurse practitioners are able to provide safe, quality care that is accessible. This is particularly disappointing in that AAFP’s statement undermines the simple fact that nurse practitioners already are and continue to improve patient access and provide safe, quality care for the patients we serve.

 

We know that nurse practitioners will continue to be at the heart of primary care delivery. Models such as the Patient Centered Primary Care Medical Home will include NPs as lead providers for a team-based approach to care that focuses on wellness, prevention and health maintenance, as well as in the diagnosis and management of acute and chronic illness.

 

It is a shame that the American Academy of Family Physicians in their report essentially chose to close the door on the option of nurse practitioners leading a medical home. Currently the Centers for Medicare and Medicaid Innovation (CMS) is piloting the Independence at Home Demonstration program in which physicians and nurse practitioners direct their own home-based primary care teams which provide comprehensive, coordinated, accessible care to high-risk populations. Before we close the door on innovative opportunities to care for the American people, let us keep an open mind to what our patients need and want. This is the spirit of patient-centered care.

 

If one looks at the historic reports of the Robert Wood Johnson Foundation (RWJF) and the Initiative on the Future of Nursing, at the Institute of Medicine (IOM), both give a clear message that nurses should be full partners with physicians and other health care professionals.

 

Research on NP-delivered care indicates that when seen by NPs, patients have increased access, quality and cost effective care. Future models of primary care delivery then must include nurse practitioners that can assess and refer to secondary providers, including physician specialists and non-physician specialists (such as oral health providers and psychiatric-mental health providers).

 

Current research on innovative nurse practitioner led models of care, such as the nurse-managed health centers and community-based clinics, demonstrate the success of NPs as team leaders for primary care. These models and their variations will continue to expand and include more integration of the full scope of primary health care services, as well as integration of primary and specialty care services, in a single setting. NPs have long been the innovators of models to get the care to the most needed populations and will continue to develop new, team-based approaches to quality primary care.

 

Nurse practitioners have gained the recognition and respect of the public and health care colleagues in health promotion, disease prevention, patient education and support for patient self-care management, for care coordination and provision of transitional care.

 

Working on the front lines of patient care, nurse practitioners can play a vital role in helping realize the objectives set forth in the 2010 Affordable Care Act. A number of barriers prevent nurses from being able to respond effectively to rapidly changing health care settings and an evolving health care system. One of these barriers is to help our physician colleagues to see nurse practitioners as allies in the evolving healthcare environment and to acknowledge the role we currently play, as well as work together to develop innovative models in response to the needs of our patients thereby advancing toward the ultimate goal; to provided quality, cost effective accessible patient centered care.These barriers need to be overcome to ensure that nurses are well- positioned to lead change and advance health.

 

The American College of Nurse Practitioners (ACNP) is a national, non-profit membership organization whose mission is to ensure a solid policy and regulatory foundation that enables nurse practitioners to continue providing accessible, high quality healthcare to the nation. ACNP’s unique membership structure, consisting of both individual nurse practitioners as well as national and state NP organizations, unites the diverse practice specialties of nurse practitioners.

Nurse Practitioners Disappointed with American Academy of Family Physicians Report

 

Alexandria, VA, September 24, 2012 – In response to the American Academy of Family Physician’s recent report entitled “Primary Care for the 21st Century: Ensuring a Quality, Physician-Led Team for Every Patient,” the American College of Nurse Practitioners President, Jill Olmstead, MSN, NPC-C, released the following statement.

 

The American College of Nurse Practitioners is disappointed that the American Academy of Family Physicians does not hold the same conviction as we do; that nurse practitioners are able to provide safe, quality care that is accessible. This is particularly disappointing in that AAFP’s statement undermines the simple fact that nurse practitioners already are and continue to improve patient access and provide safe, quality care for the patients we serve.

 

We know that nurse practitioners will continue to be at the heart of primary care delivery. Models such as the Patient Centered Primary Care Medical Home will include NPs as lead providers for a team-based approach to care that focuses on wellness, prevention and health maintenance, as well as in the diagnosis and management of acute and chronic illness.

 

It is a shame that the American Academy of Family Physicians in their report essentially chose to close the door on the option of nurse practitioners leading a medical home. Currently the Centers for Medicare and Medicaid Innovation (CMS) is piloting the Independence at Home Demonstration program in which physicians and nurse practitioners direct their own home-based primary care teams which provide comprehensive, coordinated, accessible care to high-risk populations. Before we close the door on innovative opportunities to care for the American people, let us keep an open mind to what our patients need and want. This is the spirit of patient-centered care.

 

If one looks at the historic reports of the Robert Wood Johnson Foundation (RWJF) and the Initiative on the Future of Nursing, at the Institute of Medicine (IOM), both give a clear message that nurses should be full partners with physicians and other health care professionals.

 

Research on NP-delivered care indicates that when seen by NPs, patients have increased access, quality and cost effective care. Future models of primary care delivery then must include nurse practitioners that can assess and refer to secondary providers, including physician specialists and non-physician specialists (such as oral health providers and psychiatric-mental health providers).

 

Current research on innovative nurse practitioner led models of care, such as the nurse-managed health centers and community-based clinics, demonstrate the success of NPs as team leaders for primary care. These models and their variations will continue to expand and include more integration of the full scope of primary health care services, as well as integration of primary and specialty care services, in a single setting. NPs have long been the innovators of models to get the care to the most needed populations and will continue to develop new, team-based approaches to quality primary care.

 

Nurse practitioners have gained the recognition and respect of the public and health care colleagues in health promotion, disease prevention, patient education and support for patient self-care management, for care coordination and provision of transitional care.

 

Working on the front lines of patient care, nurse practitioners can play a vital role in helping realize the objectives set forth in the 2010 Affordable Care Act. A number of barriers prevent nurses from being able to respond effectively to rapidly changing health care settings and an evolving health care system. One of these barriers is to help our physician colleagues to see nurse practitioners as allies in the evolving healthcare environment and to acknowledge the role we currently play, as well as work together to develop innovative models in response to the needs of our patients thereby advancing toward the ultimate goal; to provided quality, cost effective accessible patient centered care.These barriers need to be overcome to ensure that nurses are well- positioned to lead change and advance health.

 

The American College of Nurse Practitioners (ACNP) is a national, non-profit membership organization whose mission is to ensure a solid policy and regulatory foundation that enables nurse practitioners to continue providing accessible, high quality healthcare to the nation. ACNP’s unique membership structure, consisting of both individual nurse practitioners as well as national and state NP organizations, unites the diverse practice specialties of nurse practitioners.