"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.

Increasing Diet Polyunsaturated Fat in Place of Saturated Fat Reduces Risk of Coronary Heart Disease

Reduced saturated fat (SFA) consumption is recommended to decrease coronary heart disease (CHD), but there is an absence of strong supporting evidence from randomized controlled trials (RCTs) of clinical CHD events and few guidelines focus on any specific replacement nutrient. Additionally, some public health groups recommend lowering or limiting polyunsaturated fat (PUFA) consumption, a major potential replacement for SFA.

The overall pooled risk reduction was 19% (RR = 0.81), corresponding to 10% reduced CHD risk (RR = 0.90) for each 5% energy of increased PUFA.

These findings provide evidence that consuming PUFA in place of SFA reduces CHD events in RCTs. This suggests that rather than trying to lower PUFA consumption, a shift toward greater population PUFA consumption in place of SFA would significantly reduce rates of CHD.

References:

Mozaffarian D, Micha R, Wallace S (2010). Effects on Coronary Heart Disease of Increasing Polyunsaturated Fat in Place of Saturated Fat: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS Med 7(3): e1000252. doi:10.1371/journal.pmed.1000252
The long history of dieting fads: "soap should be eaten for its diuretic properties", wrote a prominent surgeon in 1810. Lancet, 2012.
How We Eat: Analyzing Half a Million Meals - 5 INFOGRAPHICS

Top diets of 2012 - from Cleveland Clinic health blog http://buff.ly/X2I4BJ

Image source: Varieties of meat, Wikipedia, public domain.