The April issue of Pediatric News, the newspaper for pediatricians, has a front-page story on the official position of the American Academy of Pediatrics to oppose nurse practitioners (NPs) in independent practice. It doesn’t matter that in some areas of the country, the ONLY primary care provider may be an NP or a physician’s assistant (PA).

The National Association of Pediatric Nurse Practitioners (NAPNAP) has issued a statement that points out their dismay regarding this position by their physician colleagues, noting that there is abundant evidence documenting that pediatric NPs have clinical outcomes that are comparable to those of pediatricians and asserting that NAPNAP will continue to focus on reforming health care to ensure access to care for the nation’s children.

The issue is who will control and be paid for care coordination through medical homes. Physician groups have been insistent that only practices led by a physician should qualify as “medical homes.” This means that an NP or PA in a rural area who has physician backup through telemedicine must pretend that the physician “leads” the practice—and the physician will get the fee for the care coordination even if that coordination is done solely by the NP or PA. Sounds like a good way to reduce access to care coordination, drive up costs, and put frontline practitioners out of practice. Whose interests are being served?

Diana J. Mason, AJN editor-in-chief

I was delighted to see President Obama nominate nurse Mary Wakefield to head up the Health Resources and Services Administration (HRSA) (see my posting about this on  February 20th at www.disruptivewomen.net).  I was expecting him to understand the value of having the nursing perspective represented in meetings focused on health care reform. So I am quite disappointed to be told by colleagues that there will only be a token nurse at today’s Health Care Reform Summit. Lots of physicians and insurers are there, but only the president of the American Nurses Association will represent nursing. (While I expect that Wakefield will be there, she will not be there to represent nursing.) My message to the president and those he has charged to lead health care reform: You can’t reform health care without nurses. And nurses have a lot of solutions to our ailing health care system. For examples of these solutions, look at the American Academy of Nursing’s Raise the Voice Campaign.

–Diana J. Mason, PhD, RN, Editor-in-Chief