"Family practitioners in the US are facing extinction. In their place must come nurse-practitioners" - The Lancet

From the Lancet review of the University of Pennsylvania nursing school:

Family practitioners in the US are facing extinction. In their place must come nurse-practitioners. Nurses are better educated to navigate and refer patients to specialists. They don't have any illusions about managing complex illness. Their lower threshold for referral means less risk of missing diagnoses or delaying expert care.

This is one vision for nursing to be found at the University of Pennsylvania's extraordinary School of Nursing.

I'm not sure if this is the best model for primary care in the U.S. What do you think?

References:

Offline: Nursing, but not as you know it. The Lancet, Volume 378, Issue 9805, Page 1768, 19 November 2011.
Image source: OpenClipArt.org, public domain.

Comments from Twitter:

@scanman: Looks like doctors will be an endangered genus in the US within this century

@MGastorf: so disagree. I know that is being pushed but I can provide far more complete care than nurse practitioner.

@davisliumd: Umm, No -> RT @DrVes Family practitioners in the US are facing extinction. In their place must come nurse-practitioners

@davisliumd: Agree -> RT @drves: @davisliumd that was actually a quote from The Lancet, not my opinion: j.mp/w33Kvq.

"The Clinic" at Walmart - Operated by "Family Medicine Specialists"

Medical clinics debut at Walmart stores and the photos from one Chicago location are included in this blog post (click to enlarge the images to see the details such as pricing, etc.).

Walmart has been adding health clinics to its stores during the last 3 years as part of its drive for "one-stop shopping." There were 100 in-store clinics in 21 states in 2010.

The clinics are staffed by nurse practitioners. Does that fit the description of "Family Medicine Specialists"?

Services include $14 for a pregnancy test, $29 for a flu vaccine, and $49 for treatment of a sinus infection or physical examination. The most expensive services cost $75, for treatment of bladder infections and ear wax removal.



CVS Pharmacy is not too far behind with their own model for in-store clinics called the "Minute Clinic". In fact, Minute Clinic is the largest retail clinic chain in the country, with 600 clinics in CVS stores in 24 states. Almost half of Minute Clinic's clientele don't have a primary-care doctor of their own.

A patient's mother: "The beauty of it is we're maybe 30 feet from diagnosis to pharmacy. I'm very busy and this is one-stop shopping."

References:

Medical clinic debuts at city's Walmart store
Medical clinics in retail settings are booming - USA Today.
Number of patients receiving care at retail clinics (Target, Walmart, etc.) increases http://goo.gl/9B74c
"The Family Doctor, Minus the M.D." - NYTimes keeps pushing the idea of "The Nurse as Family Doctor" http://buff.ly/R1rbn9

Comments from Twitter:

@langdon: False advertising. That would actually be sanctioned here in Ontario as per recent guidance about specialty titles from our College.

@napernurse: Pharm son works for #Walgreens. Costs them $5 to be seen by NP for whatever :) Can just walk-in & now WAG on "Blue Button" campaign.

Reinaldo B. @basanezrx: at least they are clear about the pricing, same as the clinics in Walgreens. I’d love to see specific prices for hospitals.

Some nurses paid more than family doctors - CNN

Primary care doctors were offered an average base salary of $173,000 in 2009 compared to an average base salary of $189,000 offered to certified nurse anesthetists, or CRNAs.

It's the fourth year in a row that CRNAs were recruited at a higher pay than a family doctor.

Comments from Google Buzz:

Jeffrey Benabio, MD - And soon doctor of nursing programs will graduate nurses who call themselves "doctor" in clinic. Physicians have been asleep at the wheel.

http://en.wikipedia.org/wiki/Doctorate_in_Nursing

Francesco Diana - without words

Anne Marie Cunningham - Both of these are very high salaries. As @scanman points out, they are unobtainable for most people working in health in India and countries. Can we tolerate such global inequality?

How should salaries in any part of the world be determined? Are both these groups paid too much?

At the moment there is a great deal of uncertainty on how the role of a doctor differs to the role of a nurse. Professor Alan Maynard suggests that professions are bad for healthcare. http://www.healthpolicyinsight.com/?q=node/458 What do you think?

References:
Specialist nurses paid higher salaries than family doctors - Mar. 11, 2010. CNN.
Infographic of the Day: The Best Jobs in America
http://www.focus.com/images/view/7362

Image source: OpenClipArt.org, public domain.

Doctor's family killed by kidnappers, he sues the police for slow response

A sad and terrible story.

References:
'Petrified' mom seen minutes before death. CNN.

Home invasion victim's ordeal goes on. CNN.

How To: Keep Your Family On-Board for Your Blogging Journey

Some tips from ProBlogger:

- Create Healthy Boundaries. For example, I have established a “no computer time” rule for myself where I don’t use the laptop (or my smart phone) between the time I get home from work and when we get the kids to bed. By setting up this boundary, I free my time and my mind to enjoy my children, play outside or help my wife out with dinner each evening.

- Communicate Your Reasons for Blogging. Why are you investing all this time and effort into blogging anyway? Take the time to tell your loved ones why your blog is important to you and how you see it as a benefit for your family.

- Sacrifice Personal Time, Not Family Time

- Seek Their Input

References:

7 Tips to Keep Your Family On-Board for Your Blogging Journey. ProBlogger.
Image source: public domain.