Introduction:
The purpose of this literature review was to understand the patient perceptions of nurse practitioners in primary care versus a medical physician in primary care. There is very little research that addresses patient perceptions of nurse practitioners delivering primary care versus medical physicians also in primary care. Due to the lack of research in this area, the focus of this literature review shifted to nurse practitioner and physician perceptions of nurse practitioners in primary care and patient outcomes. The one study found on patient perceptions regarding nurse practitioners delivering primary care had similar results to other studies that looked at nurse practitioner and physician perceptions in that the care delivered by nurse practitioners are standard to above standard care.
In 2010 President Barack Obama signed into law the Affordable Care Act. It was created to reform the healthcare policies in the United States. Gable (2011) states that the range of ACA provisions designed to expand insurance coverage, control costs, and target prevention has the potential to improve population-level outcomes across all income groups. He further states that by establishing a legal infrastructure that seeks to achieve universal health insurance coverage in the United States, that the ACA targets some of the major barriers to accessing healthcare for millions of Americans (Gable, 2011). One of the major components of the Affordable Care Act is health insurance being available to all U.S. citizens. The Affordable Care Act (2010) states that for Americans who have insurance that they like, they can continue to carry their current insurance but for those who are uninsured they will be able to choose insurance cover...
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...ts and limitations of nurses taking on aspects of the clinical role of doctors in primary care: integrative literature review. Journal of Advanced Nursing, 66(8), 1658-1670. Doi: 10.1111/j.1365-2648.2010.05327.x
Redsell, S., Stokes, T., Jackson, C., Hastings, A., Baker, R. (2007). Patients’ accounts of the differences in nurses’ and general practitioners’ roles in primary care. Journal of Advanced Nursing, 57(2), 172-180.
Stempniak, M. (2013). Closing the primary gap. Hospitals & Healthworks/AHA, 87(3), 45.
Street, D., Cossman, J. (2010). Does familiarity breed respect? Physician attitudes toward nurse practitioners in a medically underserved state. Journal of the American Academy of Nurse Practitioners, 22, 431-439.
Wilson, J. (2008). Primary care delivery changes as nonphysician clinicians gain independence. Annals of Internal Medicine, 149(8), 597-600.
The role of nurse practitioner in the Canadian healthcare system is relatively new compared to the traditional roles of doctors and registered nurses, and as with any new role, there are people who oppose the changes and others who appreciate them. Some members of the public and the healthcare system believe that the addition of the nurse practitioner (NP) role is an unnecessary change and liability to the system because it blurs the line between a doctor and a nurse; this is because nurse practitioners are registered nurses with additional training (usually a masters degree) that allows them to expand their scope of practice into some areas which can be treated by doctors. Other people feel that nurse practitioners can help provide additional primary care services, while bridging communication between nurses and doctors. There are always legitimate challenges to be overcome when changing a system as complicated as healthcare,
Role clarity and title confusion pose barriers to the amalgamation of advanced practice nursing roles. Colleagues and the public are unaware of the precise roles of the APN. Much of what the public knows about medicine is associated with a doctor, and the “doctor knows best” (Safriet, 2011). The public i...
Often time, nurses has been viewed by patients, their family members and the medical team as basic emotional care givers, pill crushers or cart pullers and not as healthcare professionals who are more interesting in health promotion, disease prevention and better patient outcomes. They also often forget the emotional, physical, mental, and caring part that is involved with the profession. And to make matters worse, nurses are continued to be viewed as a threat by doctors more than ever before especially with the opening of Nurse Practitioners programs.
In the United States, depending upon the state in which they work, nurse practitioners may or may not be required to practice under the supervision of a physician, frequently referred to as a “collaborative practice agreement”. However, in consideration of the shortage of primary care/internal medicine physicians, many states are eliminating or lessening the restrictive authority which allows and nurse practitioners the ability to function more autonomously (AANP 2015).
Young, W. B., Minnick, A. F., & Marcantonio, R. (1996). How wide is the gap in defining quality care?: Comparison of patient and nurse perceptions of important aspects of patient care. The Journal of Nursing Administration, 26(5), 15-20.
The Affordable Care Act or “Obamacare” was designed to assure that all Americans regardless of health status have access to affordable health insurance. The Affordable Car Act was signed into law March 23, 2010. The primary goal of this act was to decrease barriers for obtaining health care coverage and allow Americans to access needed health care services (Affordable Care Act Summary, n.d). After the legislation is fully implemented in 2014, all Americans will be required to have health insurance through their employer, a public program such as Medicaid and/or Medicare or by purchasing insurance through the health insurance marketplace exchange (Affordable Care Act Summary, n.d). I will identify three parts of The Affordable Care Act that I believe are important. First, I will talk about the requirement that insurance companies are no longer able to deny coverage to individuals with pre-existing conditions. Secondly, I will explain why physician payments are being shifted to value over volume. Lastly, I will discuss Medicaid expansion and why some states are not expanding at all.
The individual mandate and the Affordable Care Act, also known as “Obamacare”, is the idea that citizens should be required to have health insurance or otherwise pay a certain penalty. The Affordable Care Act essentially is the ability for all Americans to be able to afford health insurance. “One goal of the ACA, often referred to as the Affordable Care Act…is to bring down the costs of health care and make it available to more people.” (Will the Affordable Care Act improve health care in the United States?). The ACA was signed into law in March 2010 and currently ongoing. Although the Affordable Care Act does potentially have some positive effects to it, like bringing affordable health insurance to uninsured Americans; the Act does also have
In 2010, President Obama signed into law the Affordable Care Act in order to bring reform to the current healthcare system. The law was designed to provide healthcare coverage for people that did not have access to healthcare, improve the quality of the types of healthcare provided, and contain costs (HHS, 2014). Some of the features of the law are:
Rashid, C., (2010). Benefits and limitations of nurses taking on aspects of the clinical role of doctors in primary care: integrative literature review. Journal of Advanced Nursing 66(8), 1658-1670. doi: 10.1111/j.1365-2648.2010.05327.x
In March 2010, under the Obama administration, the United States enacted major health-care reform. The Affordable Care Act (ACA) of 2010 expands coverage to the majority of uninsured Americans, through: (a) subsidies aimed at lower-income individuals and families to purchase coverage, (b) a mandate that most Americans obtain insurance or face a penalty,
The Affordable Care Act (ACA) is a federal that was signed into law by President Barack Obama on March 23, 2010 to systematically improve, reform, and structure the healthcare system. The ACA’s ultimate goal is to promote the health outcomes of an individual by reducing costs. Previously known as the Patient Protection and Affordable Care Act, the ACA was established in order to increase the superiority, accessibility, and affordability of health insurance. President Obama has indicated the ACA is fully paid for and by staying under the original $900 billion dollar budget; it will be able to provide around 94% of Americans with coverage. In addition, the ACA has implemented that implemented that insurance companies can no longer deny c...
The Affordable Care Act, more commonly known as Obamacare, is a new health policy created by the American federal government. Its purpose is to make healthcare more affordable and friendly for the people. Unfortunately in some way that does not prove to be the case. It is becoming apparent that Obama may have made some misleading statements to help get the ACA put into action. The ACA is sprinkled with many flaws that call for a reform such as people’s current plans being terminated, high costs, and at minimum some people’s hours being cut by their employers.
The NP role exhibits many strengths within practicing that increase the patient satisfaction for the services provided. The NP is found to be holistic in nature, which encompasses the psychosocial and physical well-being of a patient into the plan of care. Barker and DeNisco (2015) pin pointed three strengths involving patient care by the NP as showing empathy, the ability to negotiate with patients and going above and beyond for the care of the patient. The NP goes above and beyond for their patients by incorporating transportation for appointments, being attentive to the patient’s availability, and including family members as requested by the patient in the plan of
A nurse has a soft corner for the patient more than the doctor also, they, honestly, do significantly more work. Anybody who is doing this amount of work deserves to be paid more. At whatever point something begins to turn out badly, the nurse is the first on the scene. He/she surveys the circumstance before the doctor even is called. The main helpful things the doctor does are work out solutions and affirm of anything the nurse does. The truth of the matter is, the nurse does it! At the point when a patient goes home, a nurse is the person who let them know about the home-care strategies. In light of the way that a doctor has, a MD does not mean that they deserve more respect than a nurse does. It does not show that one considerations more than the other. The doctors in the healing facility where I was working did not appear to mind all that much about patient consideration. They thought about getting the patients all through the doctor 's facility, which is imperative but not an essential service. The consideration that nurses give is crucial to the medical
Worldwide, nurses have developed themselves into professionals with a great deal of knowledge. Despite these developments towards professionalism, nurses are still portrayed in a misleading and inaccurate way and are not given the recognition for the skills they have acquired. The essence of nursing is not always clear and nurses still suffer from stereotypes (Hoeve,2014). A stereotype can be defined as “a cognitive representation or impression of a social group that people form by associating particular characteristics and emotions with a group” (Smith and Mackie, 2007). Of the many types of nursing, a very popular stereotype that is depicted of nurses is being doctor’s handmaiden and only performing repetitive and simple tasks (Hoeve,2014.) This public image of nursing does not match their professional images, in fact, it is quite the opposite. Nurses are strong independent individuals that play just as big a role in the hospital as due the doctors or surgeons. The problem is nurses are not depicted as professionals and the public is not aware that nursing today is very theory-based oriented and a scholarly profession. Over the last few decades, nursing gone through extensive and important