Do nurse practitioners pose a threat to family physicians?: NO.

Le Médecin de famille canadien Vol 55: january • janVier 2009 Admittedly, the concept of nurse practitioners is not new. As my colleague states, these professionals were originally created in an attempt to address the shortage of physicians, a shortage that in my view persists. Nurse practitioners have not been a panacea for this problem, which is undermining our profession. She also notes that their numbers have increased by 20% in 7 years. And to think that they were supposed to lend us a helping hand! My fears are confirmed when I hear about clinics managed by nurse practitioners in big-box stores. Nurses who break free and work independently in discount stores, without a physician: a prime example of marked-down medicine! My colleague also points out the obstacles to their training, including important limitations on their opportunities to do practical rotations at a time when faculties of medicine are experiencing an increase in enrolment. Physicians need a minimum level of exposure in order to be adequately trained. If this training were to be diluted, that would indeed pose a threat to our profession. I smiled as I read the argument regarding “malefemale issues” and the dysfunctional health care family. With admission rates of female students reaching 75% in some faculties, I think that the medical model itself is being redefined. I don’t think that female physicians fear female nurses simply because they are women! When I am told that medical support staff are not adversely affected by nurse practitioners, I tend to believe it because my understanding is that they perform different duties. But I remain sceptical about the claim that the duties performed by nurse practitioners and family physicians complement each other because I believe that many of these duties duplicate one another and overlap. Perhaps my reaction is partly based on fear, but since I have become interested in this issue, no one has been able to answer my questions regarding these half-doctors. I truly believe that cooperation is the key to success, but only when we make the best use of each individual’s talent, not when we infringe on each other’s knowledge and skills.