By Pauline Chen, MD, a liver transplant, cancer surgeon and New York Times columnist recently penned an article that calls for nurses to take a leading role in healthcare. Her November 18, 2010, article “Nurses’ Role in the Future of Health Care,” puts her at odds with the American Medical Association (AMA), which continues to insist that physicians should lead healthcare providers and patients into the future.
Dr. Chen’s article reflects the findings of the Institute of Medicine and the Robert Wood Johnson Foundation. After an extensive two-year study, the groups released a report entitled, “The Future of Nursing: Leading Change, Advocating Health.” The report recognizes nurses’ contributions to healthcare and makes suggestions for the best utilization of nurses. It states that artificial barriers have kept nurses from practicing to their full potential and recommends removing barriers that preclude nurses from leading healthcare or receiving direct payment for their services.
The American Medical Association, however, has problems with the report’s recommendations. In an official statement, the AMA states that, “A physician-led team approach to care—with each member of the team playing the role they are educated and trained to play—helps ensure patients get high quality care and value for their health care spending.” Nurses, the Association argues, aren’t nearly educated enough to take a leading role. “Nurses are critical to the health care team, but there is no substitute for education and training,” the statement continues. “Physicians have seven or more years of postgraduate education and more than 10,000 hours of clinical experience, most nurse practitioners have just two-to-three years of postgraduate education and less clinical experience than is obtained in the first year of a three year medical residency.”
The Future of Nursing Report agrees that education is essential and calls for the number of nurses with baccalaureate degrees to increase to 80 percent from 50 percent and the number of doctorate-prepared nurses to double over the next 10 years. The report further outlines concrete steps to help ensure the achievement of those ambitious goals, such as increased tuition reimbursement and salary differentials.
Dr. Chen is one physician who sees a bright future for nurses, physicians and patients. The AMA, on the other hand, seems dedicated to continued to turf warfare. What role do you think nurses should play in the future?
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