JAMA Study Shows Nurse Practitioners Provide Quality Care On Par With Physicians:Adds to body of research demonstrating NPs' effectiveness

Commenting on a study published in the January 5 issue of the Journal of the American Medical Association (JAMA), the Massachusetts Nurses Association (MNA) said that it confirms what nurse practitioners and their patients have known all along — nurse practitioners provide effective, quality primary care. 

In the study appearing in the current issue of JAMA, Columbia School of Nursing Dean Mary O. Mundinger, DrPH, RN, and her colleagues in New York compared outcomes for patients randomly assigned to nurse practitioners or physicians for primary care follow-up and ongoing care after a visit to an emergency department or urgent care center within the Columbia Presbyterian Medical Center System. 

Their study, in essence, found that patients fared just as well when they were treated by nurse practitioners as they did when treated by physicians. In fact, the study's concluding statement reads, "The results of this study strongly support the hypothesis that, using the traditional medical model for primary care, patient outcomes for nurse practitioner and physician delivery of primary care do not differ."

"We applaud the release of this important study in such a prestigious medical journal," Massachusetts Nurses Association Vice President Barbara Blakeney, MS, RN, CS, ANP, herself a nurse practitioner at Boston’s Long Island Shelter.  "It's encouraging to see the medical community recognize that NPs are excellent primary care providers for a wide range of chronic and acute health problems as well as excellent partners in care."

"This study adds to the growing body of research dating back to a 1986 government study that shows nurse practitioners are highly qualified to deliver the best level of primary care to patients in our nation's cities and rural areas," Blakeney added. 

"This a very encouraging for nurse practitioners as it underscores  the value of our practice," said Leah McKinnon-Howe, President of the Massachusetts Coalition of Nurse Practitioners (MCNP). "NPs not only provide quality care, but they listen to their patients. When they look at a patient, they see a whole person—not just an immediate diagnosis that needs to be treated. And they focus on preventive care."

Mckinnon-Howe added that the study clearly demonstrates that there is role for both nurse practitioners and physicians in the delivery of primary care, and that patients benefit most when the two disciplines work in collaboration. "I truly believe the best care is a blending of the art and science of medicine and nursing," she said.

According to Blakeney, "The results of the JAMA study echo a number of earlier studies that drive home the same point. Data going back over 20 years supports the fact that NPs can successfully manage 80 percent of the health problems adults present with and 90 percent in pediatric practices."

Previous studies that also revealed similar findings include: 

• The 1986 U.S. Office of Technology Assessment report to Congress that advanced practice registered nurses, a broad category of highly educated and skilled nurses that includes nurse practitioners, can deliver as much as 80 percent of adult care and up to 90 percent of pediatric care as proficiently as doctors, and more cost effectively. 

• A 1993 study, commissioned by the American Nurses Association (ANA), found that advanced practice registered nurses averaged 25 minutes per patient visit, while physicians averaged 17 minutes. The nurse practitioners provided more health promotion activities than did physicians, such as patient education and exercise prescriptions. The patients of the nurses were more satisfied with their health care provider, they complied with their treatment programs and they were very knowledgeable about their own health status. 

• A 1993 Gallup survey indicated that 86 percent of Americans would be willing to have a nurse practitioner manage their care. 

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