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DiversityNursing Blog

The Rise of Nurse Practitioners: Revolutionizing Healthcare

Posted by Gina Iverson

Fri, Oct 25, 2024 @ 10:56 AM

The healthcare landscape is evolving rapidly, and at the forefront of this transformation is the rise of Nurse Practitioners (NPs). With a growing shortage of physicians, an aging population, and increased demand for accessible care, NPs have become an integral part of the healthcare system. But with this rise, a question often comes up: Are Nurse Practitioners replacing Doctors? Let’s take a closer look at the role of NPs, their impact on healthcare, and whether they are a threat to the traditional role of Physicians.

Who Are Nurse Practitioners?

Nurse Practitioners are Advanced Practice Registered Nurses (APRNs) who have completed additional education and training beyond their Registered Nurse (RN) licensure. Most NPs hold a master’s or doctoral degree and are trained to diagnose illnesses, prescribe medications, and provide treatment. They often specialize in areas such as family medicine, pediatrics, women’s health, or geriatrics.

What sets NPs apart from RNs is their expanded scope of practice, which allows them to deliver primary, acute, and specialty care independently or in collaboration with a Physician, depending on the state in which they practice.

The Impact of NPs on Healthcare

Increased Access to Care One of the biggest impacts of the rise of Nurse Practitioners is improved access to healthcare, especially in underserved or rural areas. NPs are often more likely to work in these regions, helping to fill gaps in care where Physicians may be scarce. As the shortage of Doctors continues, particularly in primary care, Nurse Practitioners provide a much-needed solution, offering care to patients who might otherwise have difficulty accessing services.

Cost-Effective Care Nurse Practitioners provide high-quality care at a lower cost than Physicians, helping to reduce healthcare expenses for both patients and healthcare systems. Studies have shown, the care provided by NPs is just as effective as that delivered by Doctors for a wide range of primary and chronic conditions. With healthcare costs skyrocketing, Nurse Practitioners play a crucial role in containing costs while maintaining patient satisfaction.

Patient-Centered Approach One of the hallmarks of NP practice is a focus on patient-centered care. NPs are known for spending more time with patients, taking a holistic approach to health, and emphasizing education and prevention. This personalized care often results in better patient outcomes and higher satisfaction rates, making NPs a popular choice for many patients.

Alleviating Physician Burnout As Physician burnout continues to be a major concern in healthcare, Nurse Practitioners help alleviate the pressure by sharing the patient load. NPs can handle many of the same responsibilities as Doctors in primary and specialty care settings, allowing Physicians to focus on more complex cases. This collaborative approach benefits both healthcare providers and patients, as it leads to better work-life balance for Doctors and more comprehensive care for patients.

Are Nurse Practitioners Replacing Doctors?

While Nurse Practitioners are playing a larger role in healthcare, they are not "replacing" Doctors. Instead, they are filling a critical need, especially in primary care. The role of a Doctor remains essential, particularly in specialized fields like surgery, oncology, and complex diagnostics, where advanced medical training is required.

The relationship between NPs and Physicians is increasingly seen as complementary rather than competitive. In many settings, NPs and Doctors work together to provide high-quality care, leveraging each other’s strengths. Collaborative care models, where Physicians and NPs work in tandem, are becoming more common, leading to better patient outcomes.

State Regulations and Scope of Practice

One key factor in the rise of Nurse Practitioners is the expansion of their scope of practice in many states. Currently, 27 states and Washington, D.C., allow full practice authority for NPs, meaning they can diagnose, treat, and prescribe medications without Physician oversight. Other states have more restrictive regulations, requiring some level of Physician supervision or collaboration.

The trend toward granting NPs full practice authority is likely to continue as healthcare systems seek more flexible solutions to meet patient demand. This shift doesn't diminish the importance of Physicians but instead broadens the range of options for patients to receive timely, effective care.

The Future of Healthcare: A Team Approach

The rise of Nurse Practitioners is a positive development for healthcare. With their ability to provide quality, cost-effective care, NPs are helping to bridge the gaps in access and affordability. However, the future of healthcare isn’t about choosing between Doctors and NPs—it’s about collaboration. By working together, Doctors and Nurse Practitioners can create a more efficient, patient-centered healthcare system that meets the needs of a diverse and aging population.

In conclusion, while Nurse Practitioners are stepping into roles that were once dominated by Physicians, they are not replacing Doctors. Instead, they are enhancing the healthcare system by providing accessible, personalized care, helping to alleviate Physician shortages, and improving outcomes for patients. The future of healthcare lies in teamwork, with NPs and Physicians working side by side to deliver the best care possible.

Topics: nurse practitioners, nurse practitioner, NP, NPs

2024 U.S. NP Pay By Cost of Living

Posted by Diversity Nursing

Thu, Jun 20, 2024 @ 11:17 AM

Nurse Practitioners play a crucial role in the healthcare system, providing high-quality care to patients across the nation. One key aspect of their profession is their hourly pay, which varies significantly depending on the state they practice in. Understanding the mean hourly wages for Nurse Practitioners in each state, adjusted for cost of living, can provide valuable insights into the financial aspects of this important healthcare profession. Let's delve into the data to explore how NP hourly pay varies across the U.S. and how cost of living impacts these figures.

Below are the mean hourly wages for Nurse Practitioners in all 50 states and Washington, D.C., adjusted for cost of living. Becker's Hospital Review calculated these figures using May 2023 salary data from BLS and 2024 cost of living index data from the World Population Review.

State

NP hourly mean wage

Cost of living index

NP hourly mean wage, adjusted by cost of living

Nevada

$71.48

101.3

$70.56

Iowa

$62.89

89.7

$70.11

New Mexico

$65.76

94.2

$69.81

Oklahoma

$59.77

86

$69.50

Minnesota

$64.91

94.1

$68.98

Texas

$62.51

93

$67.22

Illinois

$61.01

90.8

$67.19

Mississippi

$56.49

85.3

$66.23

Kansas

$57.34

87.7

$65.38

Wisconsin

$61.70

95

$64.95

Nebraska

$58.50

90.1

$64.93

North Dakota

$61.42

94.6

$64.93

Indiana

$59.29

91.5

$64.80

Georgia

$58.25

91

$64.01

Wyoming

$59.40

92.8

$64.01

Missouri

$56.10

88.4

$63.46

Ohio

$59.07

94

$62.84

Michigan

$58.02

92.7

$62.59

Louisiana

$57.06

92

$62.02

South Dakota

$58.17

93.8

$62.01

Pennsylvania

$61.27

99

$61.89

Delaware

$63.03

102.6

$61.43

New Jersey

$69.73

114.1

$61.11

North Carolina

$58.46

96.1

$60.83

Washington

$69.90

115.1

$60.73

Oregon

$69.69

115.1

$60.55

Utah

$61.45

101.5

$60.54

West Virginia

$54.54

90.3

$60.40

Arkansas

$54.53

90.3

$60.39

Alabama

$52.89

88.8

$59.56

Arizona

$63.73

107.2

$59.45

South Carolina

$56.22

96.5

$58.26

Connecticut

$65.86

113.1

$58.23

Rhode Island

$64.16

110.5

$58.06

Montana

$59.92

103.7

$57.78

California

$77.66

134.5

$57.74

Kentucky

$53.06

93.8

$56.57

Idaho

$59.88

106.1

$56.44

Virginia

$58.11

103.1

$56.36

Florida

$57.55

102.3

$56.26

Colorado

$58.65

105.5

$55.59

Tennessee

$49.86

90.4

$55.15

New York

$68.67

125.1

$54.89

New Hampshire

$62.86

115

$54.66

Vermont

$61.45

114.9

$53.48

Maine

$59.11

111.5

$53.01

Maryland

$61.54

119.5

$51.50

Alaska

$60.66

124.4

$48.76

Massachusetts

$69.24

148.4

$46.66

District of Columbia

$64.83

148.7

$43.60

Hawaii

$63.76

179

$35.62

 

Topics: nurse practitioners, nurse practitioner, NP pay, NP salary

Record Number of NPs Licensed in the US

Posted by Erica Bettencourt

Tue, Apr 19, 2022 @ 11:06 AM

GettyImages-1325309684The American Association of Nurse Practitioners (AANP) reported more than 355,000 Nurse Practitioners (NPs) are licensed to practice in the U.S. This is up 9% from the estimated 325,000 reported in May 2021.

This increase in NPs will help aid the healthcare provider shortages and ease burnout from the COVID-19 pandemic. 

“Nurse Practitioners are answering the call to provide vital health care services to all Americans,” said AANP President, April N. Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN. “With the challenges of the pandemic and the demand for more accessible and equitable care, NPs continue to enhance health care delivery across all settings. Today’s Nurse Practitioner count indicates that demand for these highly-qualified clinicians continues to be on the rise — and for good reason.”

Nurse Practitioner holds the first spot on U.S. News and World Report's 2022 Best Health Care Jobs list and second on the 2022 100 Best Jobs list. 

Kapu said, “These rankings highlight what we have known for some time: the NP role is not just a job, it’s a calling for more than 325,000 NPs who are working tirelessly on the front lines of health care, from hospitals to primary care clinics, in patients’ homes and via telehealth. NPs are highly trained and committed health care providers improving the health of their patients and communities. As we enter the third year of the COVID-19 pandemic, America’s NPs will continue delivering high-quality care in every health care setting and expanding access to care in vulnerable and underserved communities. Their dedication makes me proud to be an NP.”

As of May 2021, the Bureau of Labor Statistics (BLS) lists these 5 states as having the highest employment levels for Nurse Practitioners:

  • California
  • New York
  • Texas
  • Florida
  • Tennessee 

Nurse Practitioners in the U.S. make an average of $118,040 annually, according to the BLS

Currently, more than 25 states allow NPs to practice independently. This means they can open their own clinics and treat their own patients without needing a Physician to oversee the practice.

A career as an NP is very rewarding and allows more freedom and flexibility than many other types of Nursing positions. 

Topics: nurse practitioners, nurse practitioner, NPs

Nurse Practitioner -- Laws & Regulations by State

Posted by Erica Bettencourt

Thu, Aug 08, 2019 @ 11:39 AM

NPAs a Nurse Practitioner, the state you live and work in has different laws and regulations that impact your practice. There are 3 different authorization categories -- Full Practice, Reduced Practice, and Restricted Practice. Here are the details and states for each practice.

The American Association of Nurse Practitioners defines each category below.

Full Practice
State practice and licensure laws permit all NPs to evaluate patients; diagnose, order and interpret diagnostic tests; and initiate and manage treatments, including prescribing medications and controlled substances, under the exclusive licensure authority of the state board of nursing. This is the model recommended by the National Academy of Medicine, formerly called the Institute of Medicine, and the National Council of State Boards of Nursing.

Reduced Practice
State practice and licensure laws reduce the ability of NPs to engage in at least one element of NP practice. State law requires a career-long regulated collaborative agreement with another health provider in order for the NP to provide patient care, or it limits the setting of one or more elements of NP practice.

Restricted Practice
State practice and licensure laws restrict the ability of NPs to engage in at least one element of NP practice. State law requires career-long supervision, delegation or team management by another health provider in order for the NP to provide patient care.

Full Practice States

  • Alaska
  • Arizona
  • Colorado
  • Connecticut
  • Hawaii
  • Idaho
  • Iowa
  • Maine
  • Maryland
  • Minnesota
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Mexico
  • North Dakota
  • Oregon
  • Rhode Island
  • Vermont
  • Washington
  • Wyoming

Reduced Practice States

  • Alabama
  • Arkansas
  • Delaware
  • Illinois
  • Indiana
  • Kansas
  • Kentucky
  • Louisiana
  • Massachusetts
  • Michigan
  • Mississippi
  • New Jersey
  • New York
  • Ohio
  • Pennsylvania
  • South Dakota
  • Utah
  • Virginia
  • West Virginia
  • Wisconsin

Restricted Practice States

  • California
  • Florida
  • Georgia
  • Missouri
  • North Carolina
  • Oklahoma
  • South Carolina
  • Tennessee
  • Texas

The demand for NP’s with Full Practice authority continues to increase rapidly as more Doctors choose to pursue other specialties rather than family medicine or primary care.

Do you have any comments you’d like to share about these regulations?

Topics: nurse practitioners, nurse practitioner

Can a Nurse Practitioner Do That? [INFOGRAPHIC]

Posted by Erica Bettencourt

Tue, Aug 16, 2016 @ 03:00 PM

blog_hero_CanNP_DoThat-02-e1470408521503.jpgThink you need to hire a physician to fill an opening at your hospital, practice, or organization? Not necessarily: A nurse practitioner (NP) may be able to get the job done, says Tay Kopanos, DNP, NP, the Vice President of State Government Affairs for the American Association of Nurse Practitioners. As an added bonus, it typically takes less time to find a locum tenens NP to fill an open position.

So, could bringing on an NP work for you? Use our infographic to find out www.bartonassociates.com:

NP_DO_That_R3-01.jpg

New Call-to-action

www.bartonassociates.com

Topics: nurse practitioner, NP

HOW TO BECOME A NURSE

Posted by Erica Bettencourt

Mon, Sep 08, 2014 @ 10:04 AM

By Marijke Durning

expert img

AN INTRODUCTION TO NURSING CAREERS

The path to becoming a nurse depends on which type of nursing career you’d like to pursue. You could choose to be a licensed practical nurse (LPN) or a registered nurse (RN).

An LPN program is typically one year long. Programs to become an RN are either three-year hospital-based nursing school programs (diploma), or two- or four-year college programs. Graduates from two-year programs earn an associate degree in nursing (ADN), while those who attended four-year college programs graduate with a bachelor’s of science in nursing (BSN). Successful completion of such a program allows you to write the licensing exam, called the NCLEX. Once you have passed the NCLEX, you can apply for a license to practice as a nurse in your state.

LPNs who want to become RNs may be able to follow an LPN-to-RN bridge program. This type of program is adapted for students who already have a nursing background. Registered nurses with the ADN who want to get their BSN may be interested in following an ADN-to-BSN bridge program.

Furthering your nursing education means acquiring more advanced skills and performing more critical tasks. For example, you must be a registered nurse and have at least a master’s in nursing to enter more advanced careers in the field, including nurse practitioner, nurse midwife or nurse anesthetist.

Before applying to colleges or signing up for classes, ask yourself a handful of critical questions: Do I need a bachelor’s degree to work as a nurse? What happens if I fail the NCLEX? Where will I feel comfortable starting as a nurse? Do I want to work myself up to a higher level of nursing gradually or do I want to go straight there?

The following guide helps answer these questions and illustrates the various pathways that aspiring nurses may take to pursue the career they truly want.

WHAT DOES A NURSE DO?

Although nursing responsibilities vary by specialization or unit, nurses have more in common than they have differences. Nurses provide, coordinate and monitor patient care, educate patients and family members about health conditions, provide medications and treatments, give emotional support and advice to patients and their family members, provide care and support to dying patients and their families, and more. They also work with healthy people by providing preventative health care and wellness information.

Although nurses work mostly in hospitals, they can also work in or for schools, private clinics, nursing homes, placement agencies, businesses, prisons, military bases and many other places. Nurses can provide hands-on care, supervise other nurses, teach nursing, work in administration or do research – the sky is the limit.

Work hours for nurses vary quite a bit. While some nurses do work regular shifts, others must work outside traditional work hours, including weekends and holidays. Some nurses work longer shifts, 10 to 12 hours per day, for example, but this allows them to work fewer days and have more days off.

COMMON SKILLS FOR NURSES

Good nurses are compassionate, patient, organized, detail oriented and have good critical thinking skills. An interest in science and math is important due to the content of nursing programs and the technology involved. Nurses must be able to function in high stress situations and be willing to constantly learn as the profession continues to grow and develop.

TYPES OF NURSING CAREERS

If you choose to become an LPN, you will likely provide direct patient care under the supervision of an RN or physician.

Registered nurses have more autonomy than LPNs, and the degree of care they provide depends on their level of education. An RN with an associate degree generally provides hands-on care directly to patients and can supervise LPNs. There may also be some administrative work. An RN with a BSN can take on more leadership roles and more advanced nursing care in specialized units, for example.

Nurses can continue to get a master’s degree in nursing (MSN) and become nurse practitioners, nurse midwives or nurse anesthetists. These are called advanced practice nurses (ARPNs). They have a larger scope of practice and are more independent.

Licensed Practical Nurse (LPN)

An entry-level nursing career, LPNs provide basic care to patients, such as checking vitals and applying bandages. This critical medical function requires vocational or two-year training plus passing a licensure examination.

Neonatal Nurse

This specialization focuses on care for newborn infants born prematurely or that face health issues such as infections or defects. Neonatal nursing requires special skill working with small children and parents.

Nurse Practitioner

A more advanced nursing profession, nurse practitioners engage in more decision-making when it comes to exams, treatments and next steps. They go beyond the reach of registered nurses (RNs) and may work with physicians more closely.

Registered Nurse

Registered nurses are the most numerous in the profession and often serve as a fulcrum of patient care. They work with physicians and communicate with patients and their families. They engage in more sophisticated care than LPNs.

Source: www.learnhowtobecome.org

Topics: neonatal nurse, registered nurse, licensed practical nurse, how to, nursing, health care, nurse practitioner, career

Affordable Care for Those Uninsured

Posted by Alycia Sullivan

Wed, Apr 16, 2014 @ 12:01 PM

The following is a script from "The Health Wagon" which aired on April 6, 2014. Scott Pelley is the correspondent. Henry Schuster and Rachael Kun Morehouse, producers.

President Obama announced last week that more than 7 million people have signed up for Obamacare. But what went unsaid is that almost as many people have been left out. Millions of Americans can't afford the new health insurance exchanges. For the sake of those people, Obamacare told the states to expand Medicaid, the government insurance for the very poor. But 24 states declined. So, in those states, nearly five million people are falling into a gap they make too much to qualify as "destitute" for Medicaid, but not enough to buy insurance. We met some of these people when we tagged along in a busted RV called the Health Wagon -- medical mercy for those left out of Obamacare.

The tight folds of the Cumberland Mountains mark the point of western Virginia that splits Kentucky and Tennessee -- the very center of Appalachia -- a land rich in soft coal and hard times. Around Wise County, folks are welcomed by storefronts to remember what life was like before unemployment hit nine percent.
Teresa Gardner: The roads are narrow and windy curves. So it's not easy to drive the bus.

This is Teresa Gardner's territory. She can't be more than 5-foot-4 but she muscles "the bus" through the hollers, deaf to the complaints, of a 13-year-old Winnebago that's left its best miles behind it.

Teresa Gardner: Having problems seeing here.

Scott Pelley: You really can't see.

The wipers are nearly shot and the defroster's out cold.

Scott Pelley: There you go, you can see a little better now. I understand there's a hole in the floorboard here somewhere?

Teresa Gardner: Yes, it's right over there so don't get in that area.

The old truck may be a ruin but like most RVs it's pretty good at discovering America. Gardner and her partner, Paula Meade, are nurse practitioners aboard the Health Wagon, a charity that puts free health care on the road.

[How many patients do we have on the schedule today?

He was going to see what he can free up for us.]

The Health Wagon pulls up in parking lots across six counties in southwestern Virginia.

[Y'all come on in out of the rain.]

It's not long before the waiting room is packed.

[Hello Mr. Hank, how you doing?]

And two exam rooms are full. With advanced degrees in nursing, Gardner and Meade are allowed to diagnose illnesses, write prescriptions order tests and X-rays.

[Stick it out, ahhh.]

On average there are 20 patients a day, that's recently up by 70 percent. The Health Wagon is a small operation that started back in 1980. It runs mostly on federal grants and corporate and private donations.

[Blood pressure a bit high before?

Just when I get aggravated.]

Scott Pelley: Who are these people who come into the van?

Paula Meade: They are people that are in desperate need. They have no insurance and they usually wait, we say, until they are train wrecks. Their blood pressures come in emergency levels. We have blood sugars come in 500, 600s because they can't afford their insulin.

Scott Pelley: But why do they not see a doctor or a nurse before they become, as you call it, train wrecks?

Paula Meade: Because they don't have any money. They don't have money to pay for labs. They don't have money to go to an ER and these are very proud people. They, you know, you go to the ER, you get a $3,500 bill. And then what do you do? You're given a prescription, you can't fill it. That's why they're train wrecks. They have nowhere else to go.

Glenda Moore had nowhere to go but the ER when the pain in her leg became unbearable. Her job at McDonald's, making biscuits, didn't include insurance that she could afford.

Glenda Moore: The only doctor that would see me-- you had to have $114 upfront just to be seen.

Scott Pelley: What does $114 mean to your monthly budget?

Glenda Moore: Oh my gosh. That's half of my weekly pay. I make $7.80 an hour. My paycheck was about after taxes about $475 every two weeks.

The pain was from a blood clot. She needed Lovenox, a clot buster that cost about $500 for a full treatment.

[Paula Meade: Was she on Lovenox when she was discharged from the hospital?]

Paula Meade got the call from the ER, which didn't want to bear the cost. The Health Wagon had the drug for free and there was no charge for some stern medical advice.

Paula Meade: You are going to die if you don't quit smoking and it could be within a week. You need to stop now! OK?

She took the advice to stop smoking and took Lovenox but one day she felt so bad she went back to the ER.

Glenda Moore: And they did a CAT Scan and an X-ray and found the blood clot had went to my lung. But they also saw another mass on my lung. And then transported me to a bigger hospital. They found the lesions in my brain, so I was diagnosed with stage IV lung cancer and brain cancer.

Scott Pelley: What are the doctors telling you?

Glenda Moore: I start my treatment on Monday, the brain radiation, and he seemed very, I mean he seemed optimistic.

Scott Pelley: Are you hopeful?

Glenda Moore: I am. I have been. I don't know, I just feel very hopeful.

Hope, especially when the odds are long, has always been essential to survival in Appalachia. The recovery from the Great Recession hasn't arrived. In coal these days they just take the top of the mountain and you don't need many men for that. Around here a thousand were laid off in the last two years. Twelve percent of the folks don't have enough to eat. And we met them waiting for their number at Zion Family Ministries Church where a charity called Feeding America was handing out just enough to get through a week -- if you stretch. 1,654 lined up -- a parking lot of possibilities for the Health Wagon, Gardner and Meade. They've known these people and each other most their lives. 

Scott Pelley: You've been together since 8th grade?

Paula Meade: Eighth grade. Yes.

Scott Pelley: Why do you do this work?

Paula Meade: Because somebody has to. You know, there's people here, you know, we always, we had dreams. We wanted to move away from here. We all, you know, we did. And then we come back and we saw the need. And actually there's a vulnerable population here that's different from the rest of America. I mean there are people, you can replicate this. But we're kind of forgotten. There's no one here to take care of 'em but us.

These patients would be taken care of in the 26 states that expanded Medicaid under Obamacare. The federal government pays the extra cost to the states for three years but Virginia and the others that opted out fear that the cost in the future could bankrupt them. So the health wagon patients we met have fallen through this untended gap.

[Do you have insurance?

No ma'am.]

Scott Pelley: Have any of you tried to sign up for the president's health insurance plan?

Voices: No--

Scott Pelley: Why not?

Brittany Phipps: I can't afford it.

Sissy Cantrell: I can't either.

Sissy Cantrell was laid off from a head start center. She's been suffering from migraines and seizures.

[I cry for no reason at all. OK.

Have you been seeing a counselor?

No.

OK.]

She came away from the Health Wagon with medication.

[I did want to ask you....]

Brittany Phipps works more than 50 hours a week, but that's two part-time jobs so there's no insurance for her diabetes.

Scott Pelley: So you're getting your insulin through the Health Wagon?

Brittany Phipps: I am now. Yeah.

Scott Pelley: And if that wasn't available, where would you get the insulin?

Brittany Phipps: I don't know.

Walter Laney's diabetes blinded him in one eye and threatens the other. The Health Wagon stabilized him and set him up with a specialist.

[Hey Walter, this is Dr. Isaacs, how's it going?

Pretty good.

How've you're sugars been?

OK.]

Walter Laney: They got my blood sugars back under control. Before this year, I was in the hospital three, four times and this year, I ain't been in none since I've been seeing them. If it hadn't a been for them, I don't think I'd be here today.

Outside the church where they were handing out food we met Dr. Joe Smiddy, a lung specialist who's the Health Wagon's volunteer medical director.

Joe Smiddy: This is a Third World country of diabetes, hypertension, lung cancer, and COPD.

Dr. Smiddy drives a second Health Wagon, a tractor-trailer X-ray lab.

Scott Pelley: I guess they taught you something about radiology and all of that in medical school. Did they teach you how to drive an 18-wheeler?

Joe Smiddy: I did have to go to tractor-trailer school. And it took a long time.

Scott Pelley: Was that harder than medical school in some ways?

Joe Smiddy: It was very difficult to get anyone to insure a doctor to drive a tractor-trailer. The insurance companies didn't believe me.

His X-ray screen is a window on chronic, untreated disease including black lung from the mines.

Joe Smiddy: We've seen coal workers pneumoconiosis, emphysema, COPD, enlarged hearts. There's 15 of the 26 had significant abnormalities here today.

Scott Pelley: Just today?

Joe Smiddy: Just today.

Scott Pelley: But when they leave your Health Wagon, they still don't have health insurance. How do they get treated for these things that you're finding?

Joe Smiddy: We negotiate. We can talk to the hospital system. We don't leave any patient unattended. We raise money for them.

Scott Pelley: You find a way.

Joe Smiddy: We will find a way.

They found a way to get Glenda Moore radiation for her brain cancer. But she'd been a smoker for 25 years. And she died three months after our interview.

Scott Pelley: You don't like this idea of receiving charity?

Glenda Moore: No. Oh, I hate it. My dad was in the military. And when he was diagnosed with cancer, he was taken care of. And I don't know, I just always assumed, you know, that's how it would work.

Scott Pelley: Do you think things would've been different if you'd had an opportunity to go to a doctor more often?

Glenda Moore: Oh, definitely. I know it would be different.

The outreach to all the people like Glenda Moore costs the Health Wagon about a million and a half dollars a year, a third of that is from those federal grants, and the rest from donations. Doctors volunteer and pharmaceutical companies donate drugs. But when we were with them...

[We got no electricity on the health side.]

...they sure could have used a new truck battery.

[There goes.Yay! ]

Teresa Gardner: Can we give you all a free flu shot for helping us?

Man: Need a free flu shot, Beaver? Nope. Ok.

Teresa Gardner and Paula Meade apply for grants. And travel to churches praying for donations and passing the plate.

Scott Pelley: Are there days you say to yourself, "I can't do this anymore."

Paula Meade: Oh, every day. Not every day. I shouldn't say every day. There are a lot of days you get frustrated because we're writing grants till 10:00 at night. We're begging for money. And you're almost in tears because we're like, "OK, what are we gonna do," because I've got a family too. It gets frustrating, it gets hard.

Scott Pelley: It's enough to wear you out, Teresa.

Teresa Gardner: We're pretty beat down by the end of the day on most days really. But we do get more out of it then we ever give.

Paula Meade: When you look at it practically, you think, "What in the world am I thinking?" But then I have that one patient that may come in and say, "Couldn't bring you anything, can't pay anything but here's a quilt I wanna give you." And I mean when they do that and they're so heartfelt and you just-- and they put their arms around you, "I don't know what I'd do without you..."

[You're doing a lot better.]

Paula Meade: It lets you think, "OK, I was put here for a purpose."

Teresa Gardner: And you can do it another day.

[You're a blessing to us.

Well thank you all. You're blessing us. ]

Teresa Gardner: It's them and that's what touches our heart.

This week in Virginia, there is a crisis at the capital where the new Democratic governor is demanding Medicaid expansion from the Republican House. But neither side will budge and now there's a threat of a government shutdown in that state. There's no shutting down the Health Wagon though. Gardner and Meade have raised money for a new truck and they hope to get it on the road in the spring.

Source: 60 Minutes 

Topics: Appalachia, Obamacare, Medicaid, health care, nurse practitioner

Rise of the Nurse Practitioner

Posted by Alycia Sullivan

Fri, Mar 21, 2014 @ 12:33 PM

TheRiseoftheNursePractitioner 2 27 resized 600

TheRiseoftheNursePractitioner 2 27 resized 600Source: Maryville University 

Topics: growth, education, nursing, online, nurse practitioner

6 Advantages of Becoming a Nurse Practitioner

Posted by Alycia Sullivan

Fri, Dec 20, 2013 @ 10:19 AM

By Nursing at Ohio University 

advnursepractitioner resized 600

Topics: opportunities, Ohio University, nurse practitioner, benefits, salary

Ping! New App Allows Patient-Provider Texting

Posted by Alycia Sullivan

Wed, Nov 13, 2013 @ 11:05 AM

By Erin Tolbert, RN, MSN for MidlevelU.com

pingmd resized 600While there are plenty of apps out there promising to make my life as a nurse practitioner easier, once downloaded to my phone they go largely unused.  Rarely do I calculate pediatric dosages with special programs, rather I go straight for pen and paper.  I don't check apps streaming medical news- the last thing I want to do after work is be inundated with more information from the world of medicine.  But, this week I stumbled across a true winner in the healthcare app world.  PingMD, an app that facilitates patient-provider texting offers real value to NPs.

When I heard about the new PingMD app, I was thrilled that someone had finally come up with a way to bring patient-provider communication into the 21st century.  The medical world is notoriously behind technologically and I was excited by the prospect of weaving my favorite form of communication, texting, in with my work.  So, I decided to contact the app's creator, neurosurgeon Dr. Gopal Chopra, to get the story behind PingMD.  Here's what he had to say about bringing texting to the patient-provider relationship.

What inspired you to develop a way for providers and patients to text?

Dr. Chopra explains that his wife is a pediatrician who initially sparked his idea for the texting app.  She described what she saw as "spillover".  Office visits with patients are getting shorter and shorter.  When patients don't retain the information they get from visiting their healthcare provider, or are unable to reach them during a time of need, they end up in the emergency department.  If she had known about the patient's problem, Dr. Chopra feels that she could have prevented the patient from going to the emergency room, and probably answered their question or given them direction for their medical problem in just a few seconds.  But, without an easy way to communicate, she is unable to avert unnecessary emergency department visits. 

Dr. Chopra also describes the experience in his own clinic. The nurse practitioner in Dr. Chopra's neurosurgery office takes about 80 percent of patient calls. He describes that it only takes this NP about 30 seconds to decide the best course of action for the patient. The problem with patient-provider communication isn't that providers don't know the best course of action for their patients, it’s the communication system that's broken.  PingMD, Dr. Chopra's new app solves this problem.

We all know HIPAA is a major barrier to streamlining patient-provider communication. Does PingMD comply with HIPAA?

When I ask this question, Dr. Chopra brings up an excellent point.  In order for communication to be secure, it must do so from both the patient and provider's end.  This is why texting between patients and providers can be difficult.  Even if the provider's phone is secure, the patient's phone may not have necessary privacy and security measures in place.  The PingMD app addresses this issue.

PingMD complies with HIPAA regulations through password protection, requiring authentication and encrypting stored information on the end of the patient and provider. 

How much does PingMD cost patients?  Providers?

PingMD creates obvious value for medical practices, so I decide to get to the bottom-line asking Dr. Copra about pricing.  I'm shocked by his reply.  The PingMD app is free!  Both healthcare providers and patients are welcome to create PingMD accounts free of charge and begin texting.

PingMD does charge for one service.  The app has the ability to integrate with electronic medical records recording the text conversation in the patient's personal medical record.  This saves you as a provider from going back to record the conversation later, well worth the expense. 

Most providers don't like taking calls from patients after-hours.  Isn't allowing your patients to text you even more intrusive to your private life?

I think I have thrown Dr. Chopra a zinger here. During my time working as a primary care nurse practitioner, I dreaded hearing my work phone ring. It meant a great deal of work to follow. First, I would talk with the patient, then possibly call a medication in to the pharmacy, followed by opening my laptop to record the interaction...on a Saturday evening.  I imagine that by making communication easier, communicating with patients will require even more of my weekend time. Quickly, I see that I am mistaken.

Dr. Chopra explains that texting patients makes being on-call a more palatable prospect. Rather than interrupting your day to answer the phone, PingMD allows you to answer a patient's questions with a simple text message. If your practice pays for PingMD, this message is then integrated into the patient's health record eliminating the need to record the interaction. Texts from patients using PingMD are confined within the app keeping your personal and work-related texts separate.  Overall, texting is a more efficient, less invasive way to communicate with your patients than phone. 

How have providers seen PingMD improve their practice?

Dr. Chopra says providers of all backgrounds, from primary care to anesthesiology clinics, love to ping.  Not only does it make communication with patients easier on the provider-side, it also increases patient satisfaction.  Sounds like a win-win situation. 

The idea behind PingMD is simple, but seamless patient-provider texting just might revolutionize your practice. 

Topics: PingMD, text, provider to patient, apps, technology, nurse practitioner

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