Wednesday, June 29, 2011

Nurse Practitioners and Midwives

I have long celebrated both.

 It was thirty years ago, when pregnant with my first child, that OB/GYNs were fighting the accreditation of midwives. Now, they are an acceptable part of a practice. They have hospital privileges, and provide intense support, and home care.
For low-risk births, these professional midwives provide pre- and postpartum information and counselling on breastfeeding, as well as caregiving, something OB/GYNs often do not understand.

A recent US-based study tells us that many prefer Nurse Practitioners (NP) over physicians.
In general, the findings indicated that NPs spend more time with patients, listen more closely, provide more feedback, show more respect for patients' opinions, and the like. Note: Researchers point out that physicians scored well on the survey--an average global score of 7.2 out of 10. In comparison, however, NPs earned an global average of 9.8.

While this study is simply an opinion poll, it reflects the service received by US patients.
In fact, the Ontario movement to create Family Health Teams, seems to be the way to streamline services.

What does a patient want from a nurse?

The kind of service midwives provide.I hope that physicians will come to accept working in a fully-integrated healthcare system.

Dr. Brian Goldman, of White Coat Black Art, ER physician, book author, radio host, tweeted:

Study: Patients prefer NPs over physicians: MDs who don't realize it are like frogs in a pot of slowly heated water.

This will not replace physicians, but it will ease up the healthcare system. If we have NPs who can make house calls, to provide better homecare to frail seniors, this will add to the Aging at Home strategies.

I hope that GPs will realize what they do NOT know about geriatrics, we have far too few geriatricians in Canada.
We have many more nurses trained in palliative care and pain management.

Our Nurse Practitioners, caring for seniors in an integrated Family Health Team practice, provide much-need, personal care that a busy physician cannot provide.

To get an appointment is much easier with the NP. I had a precancerous skin issue. I visited my NP every two weeks to have it zapped. I didn't have to wait months to have it taken care of, I could make appointments as the treatment (liquid nitrogen) was a 10-minute procedure.

To learn more:
- read the Medscape Medical News story
- check out The Clinical Advisor's take

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