March 30, 2015
Healthcare Is a Team Sport; Nurses Are Key Players
Editor's Note: A two-part documentary, Rx: The Quiet Revolution, will air on PBS on April 2. Reflecting on his physician father's practice and the move away from hands-on care in contemporary medicine, the documentary's award-winning director, David Grubin, highlights a range of innovative practice models from Maine to Alaska. Medscape asked a number of our experts to preview the film and offer us their reactions and opinions about how well the documentary depicts the healthcare system as they know and live it.
In this commentary, Ken Miller, a nurse practitioner and president of the American Association of Nurse Practitioners, offers us his perspective.
The documentary Rx: The Quiet Revolution provides a changing perspective on how healthcare should be delivered in this country. It no longer works for any healthcare provider to assess, diagnose, treat, prescribe, and interpret tests without consulting the patient. We have entered into an era that is long overdue, in which we are must create a partnership with patients. Basically, we are putting the "care" back in patient care.
One segment of the documentary highlights a "new breed" of physician who has begun to make house calls. Physicians are not the only healthcare providers making house calls. Others—nurse practitioners (NPs) and community health nurses—are also providing home-based healthcare. The PBS program focuses primarily on the physician discipline, and I believe that other healthcare professionals who are engaged in identical work should also be highlighted. From that perspective, the program is fairly myopic in its presentation.
In many ways, the changes that this program proposes are things that NPs have been doing for the past half century. All NPs are educated in prevention. That is our hallmark, and the foundation of our practice. This program highlights what occurs daily in our offices and clinics: focusing on prevention, working collaboratively with other clinicians, and partnering with patients.
Given the prevalence of major chronic disease conditions in this country, such as obesity, hypertension, and diabetes, we have to find better ways to care for our patients. The days of dictating to patients what we want them to do are gone. It is better to prevent a disease than to try and treat it ex post facto.
Healthcare progress in the future will focus on working collaboratively with patients to achieve their goals, not ours. We can't make people do what we tell them, but what we can do is educate them about how they can improve their health, and we can provide the support that they need to achieve their goals.
Healthcare has also become a team effort; no single discipline is able to handle the volume of patients entering into primary care. No discipline works independently—we all rely on one another for expertise that exists outside our scope of practice. Rather than get into turf wars over scope-of-practice issues, clinicians need to work together to provide the best care that we can for every patient who we see. There is more than enough work for all of us.