The Expanding Role of Nurse Practitioners and Its Impact on Immunotherapy

I am taking part in a positive shift in healthcare— a shift in which NPs are becoming empowered to provide patient care and specialized services more than ever before.”
August/September 2014, Vol 2, No 4 - Inside Pharmacy
Kevin Letz, DNP, MBA, MSN, RN, CNE, CEN, FNP-C, ANP-BC, PNP-BC

Today, the US healthcare system faces a mounting shortage of general practitioners, rising costs of running a primary care practice, and growing patient demand for healthcare services. This trifecta has created a conundrum for providers: how can physicians’ practices reduce costs without negatively impacting quality of care? With an influx of 30 to 33 million newly insured patients anticipated by 2016 as a result of Affordable Care Act legislation, according to an estimate from the Congressional Budget Office,1 healthcare demand and cost pressures are only anticipated to climb.

A key resource to address physician shortages, improving efficiency in primary care, and ultimately increasing access to healthcare for many more patients lies with the nurse practitioner (NP). As an NP, I am taking part in a positive shift in healthcare—a shift in which NPs are becoming empowered to provide patient care and specialized services more than ever before. An empowered NP staff can provide medical practices with desperately needed flexibility and cost-savings in a time of increased economic pressure.

NPs’ Reach Extends to Retail Clinics
NPs are well-equipped with sufficient medical education and training to function as primary and specialty care providers for many patients. Meanwhile, this role typically requires less compensation than a physician. Because NPs are able to write prescriptions, diagnose many conditions, and offer a flexible approach to treating the whole patient, they are a valuable asset to many practices, even helping some to increase profit margins.

As NPs become more empowered, their role has started to expand its reach. Although the core responsibilities of NPs have remained relatively constant for decades, the profession is navigating away from traditional primary care roles to a variety of other settings, including inpatient and retail medicine.

NP Specialization
A growing number of NPs, including myself, are also choosing to be more specialized in their work. For example, NPs provide allergy testing and immunotherapy directly to patients. This specialization helps to improve access to therapy for more patients and increases healthcare efficiency.

Immunotherapy is aspecialty service that can benefit a far greater number of patients than those who currently have access to it. Unlike over-the-counter treatments, which are short-term remedies and typically do little more than mask patients’ allergy symptoms, immunotherapy, also known as allergen-specific subcutaneous immunotherapy, is the only long-term relief from allergies and can even prevent the progression of the condition. Yet, the significant patient need for allergy care—allergies are one of the single most common chronic conditions in the United States2—combined with the insufficient number of board-certified allergists to meet patient demand, creates a health-care challenge.

According to the Centers for Medicare & Medicaid Services, only approximately 50% of patients who receive allergy shots are currently being treated by an allergist,3 mostly because of the lack of supply. The rest of the patients are treated by ear, nose, and throat physicians and primary care physicians. More NPs providing allergy and asthma care could free up these physicians to focus on other areas of patient care, including acute allergy cases that require a specialized allergist.

An NP workforce that is skilled and empowered with the ability to deliver specialty services, such as immunotherapy, provides an opportunity to bridge this gap and improve access for a majority of patients needing allergy care.

The Time Is Now for NPs
NPs are a welcomed asset in today’s healthcare landscape. Primary care has already been taking on more of the straightforward allergy cases and, with more NPs joining primary care offices or working in retail clinics, these practices have the opportunity to fulfill a common patient need.

By increasing specialty service offerings, medical practices cannot only boost patient satisfaction, but also attract new patients and gain revenue opportunities. Now is a good time to be an NP. A key benefit of the NP role is the flexibility that it offers. We are able to pursue different specialties in healthcare, expand our skills and experience in new ways, and, ultimately, devote our time to the most pressing patient needs and our own career interests.

The demand for NPs has always existed, but today, it is growing. Not surprisingly, more of us entering the healthcare field are opting for careers as NPs—in fact, the number of NPs has been forecasted to double by 2025, according to a study in Medical Care.4 Physicians, medical practice administrators, and patients alike stand to benefit from this growth with opportunities to improve the efficiency and accessibility of patient care.

References

    1. Congressional Budget Office. Updated Estimates for the Insurance Coverage Provisions of the Affordable Care Act. March 2012. www.cbo.gov/sites/default/files/cbofiles/attachments/43472-07-24-2012-Coverage­Estimates.pdf. Accessed August 20, 2014.
    2. Centers for Disease Control and Prevention. Allergies. Updated February 2, 2011. www.cdc.gov/healthcommunication/ToolsTemplates/EntertainmentEd/Tips/Allergies.html. Accessed August 20, 2014.
    3. Academy of Allergy & Asthma in Primary Care. Academy of Allergy & Asthma in Primary Care Provides a Voice for PCPs for Allergy and Asthma Care and Prevention. February 2013. www.aaapc.us/academy-of-allergy-asthma-in-primary-care-provides-a-voice-for-pcps-for-allergy-and-asthma-care-and-prevention. Accessed August 20, 2014.
    4. Auerbach DI. Will the NP workforce grow in the future? New forecasts and implications for healthcare delivery. Med Care. 2012;50:606-610.
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