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Nurse practitioners, physicians assistants fill the doctor gap


Nathan Gregory



Barring a dramatic increase in the number of doctors in the U.S., Columbus nurse practitioner Mary Chance-Peeler should have a job as long as she wants one. 


According to a report from Irving, Texas-based physician staffing company, Staff Care, a shortage of physicians in the United States, coupled with the approaching implementation of the Affordable Care Act, is prompting healthcare facilities to expand the role of primary care providers. The report states two groups of professionals in the field are chief among the expansion -- nurse practitioners and physician assistants. 


Chance-Peeler, who works full time at Baptist Memorial Hospital-Golden Triangle and part-time at a family practice, says she saw the growing need for people in her field, especially at smaller clinics. 


"I think it's definitely true, because you have less physicians wanting to do family practice," she said. "That's a role nurse practitioners function well in." 


A recently announced collaboration between Mississippi University for Women and North Mississippi Health Services is designed to address the growing needs by bringing aspiring professionals in each of those fields together in an integrated residency training program, according to Karen Hughes, North Mississippi Medical Center Family Medicine Residency Center associate director.  


Hughes, who will serve as the program's medical director, said the one-year Advanced Practice Clinicians Residency Program would allow students course credit in the doctor of nurse practice program at MUW and build new opportunities for health care delivery by preparing them for primary care responsibilities through training with family medicine physicians. 


"It offers more providers to be able to see patients who need primary care and the clinic benefits from the extra training because it could hire graduates of the program," Hughes said. "Putting the two residences together in training ... promotes a collegiality between (nurse practitioners and physician assistants) working together." 


Nurse practitioners are registered nurses with advanced academic and clinical experience that qualifies them to diagnose common illnesses. Physician assistants are trained to interpret X-rays and laboratory tests to treat injuries as delegated by physicians. Both groups are already in short supply, according to the Staff Care report. With an additional 30 million people being provided insurance beginning next year through the national health care plan, many more than the current estimated 155,000 nurse practitioners and 83,000 physician assistants will be needed. The report stated professionals in those practices can perform up to 80 percent of the services typically provided by physicians. Staff Care estimates that 85 percent of nurse practitioners are already providing primary care. 


Hughes said the new program between NMMC and MUW will be focused on providing an adequate number of primary caregivers in Mississippi. 


"The problem is there are not enough primary care physicians. In order to meet demand, nurse practitioners can act as care extenders because they can practice with off-site supervision from physicians," Hughes said. "This provides a valuable increase in appointment time slots and frees up positions for physicians to take care of more complicated cases." 


Chance-Peeler, a graduate of MUW's nursing program at the bachelor's and master's levels, said she typically works closer with a physician at Baptist. There, she said she treats adult patients hospitalized with conditions such as heart failure and pneumonia. In her clinic work, she works primarily without supervision. 


"At the family practice, I'm more independent," she said. "It's just me and no physician, but physicians overview my charts each month." 


MUW President Jim Borsig said the new program is a continuation of a long-standing partnership with NMMC. 


"This partnership has been built through working at the community level. We have worked to raise the level of the nursing profession over the past 40 years," Borsig said. "We've always been a community based partner with Tupelo and have the second largest nursing program in the state. We think this collaboration is going to improve the quality of health care and the quality of life in Mississippi." 


Chance-Peeler said if an opportunity such as the one just announced by MUW and NMMC had been available when she was in school, she would have been open to it. 


"I think it would provide more hands-on experience and would make people in each field more familiar with each others' role and training. The degrees are different but I think the end result is a similar provider," she said. "There are different areas in Mississippi that have health care shortages and the state has those type clinics that can recruit nurse practitioners."


Nathan Gregory covers city and county government for The Dispatch.



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