Growing demand for primary & speciality care…how about a nurse practitioner?

It is estimated that in about 2 years we will be short approximately 29,000 physicians in the United States. By 2020 that number is excepted to grow to somewhere near a deficit of 45,000 physicians. Whether the demand for primary and specialty care comes from the “baby boomers” or from the increase in access to care, now that many more people have access as a result of the Affordable Care Act. The demand for care is not going away and it it is only going to increase as time goes on. Many practices are faced with the challenge of determining how to keep their overhead as low as possible, while still maintaining their current patient panel & attracting future patients as well, and also providing all of their patients with high quality care.  Some experts believe that the deficit of physicians leaves a void that can be filled by medical professionals like nurse practitioners.  A new trend among the health care industry is looking towards nurse practitioners to provide primary care services in collaboration with a physician. This model of care seems to be working because the trend is growing across the U.S. and abroad & nurse practitioners are in very high demand. However there appears to be a gap in the current number of physicians and the number of active nurse practitioners and physician assistants. But data also shows that there have been an increase in enrollment in both career fields, which makes many experts hopeful about the future. Yet they are still cautious about what is to come in the next few year  to help with the growing number of people that will be seeking medical care immediately.

Instead of patients having to wait weeks to be seen at a practice that is understaffed or seeking another physician who can see them sooner.  By adding a nurse practitioner to one’s practice; patience are afforded a continuum of care by establishing & maintaining a relationship with a primary care physician and/or a medical home. The primary care physician becomes the nucleus of their health care. . The nurse practitioner typically works in collaboration with the physician to provide care for patients, and ultimately this will improve the patient’s health care, and improve upon overall clinical outcomes. Nurse Practitioners can perform just about everything that physicians can do and they can work in a variety of settings pretty autonomously. They can work in inpatient or outpatient settings, diagnosis & treat medical conditions, prescribe medications (depending on the state), perform procedures, and admit patients to the hospital.


In North Carolina in order for a nurse practitioner to practice they are required to have a collaborative agreement in place with a Primary Supervising Physician, according to the North Carolina Board of Nursing. Over the past few years here has been some push for states to eliminate the collaborative agreement after nurse practitioners have been practicing for a few years. In some cases the agreement becomes a barrier for those nurse practitioners who want to practice on their own and or who are not at the same practice as their Primary Supervising Physician. And in other cases  some nurse practitioners have been asked to pay high rates as somewhat of a “supervision fee” by their supervising physician.”

Over time it seems that more physicians will become more  open to the idea of working with nurse practitioners. Eventually they will see the value of what they can bring to their practice, while also providing a cost effective alternative to hiring another physician. There seems to be a growing demand in requests to recruit nurse practitioners from a staffing perspective as well. Perhaps with the growing demand for nurse practitioners we will see some changes in the way that they are governed & managed over the next few years- since they are reporting to the state nursing board and the DEA at the federal level.

It’s almost the weekend, hang in there!

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Today’s Blog is dedicated to 2 of our favorite nurse practitioners Mrs. T. Gibson & Ms. T. Starkes- two amazing, overachieving, talented, & intelligent, nurse practitioners that we would let treat us any day! We love you ladies! XOXO


Blue Cross to offer gay N.C. couples family policies

Big news for same-sex couples in North Carolina. North Carolina’s largest health insurance company, Blue Cross and Blue Shield of NC has decided to reverse a systematic decision that took affect in mid-January. The decision lead to the cancellation of 20 policies for customers who were same-sex couples. After much embarassment, the company’s CEO issued a public apology. Along with the apology Blue Cross’ CEO also admitted that the company should have given more thought and consideration before making the decision to cancel policies. Blue Cross actually provides coverage to same-sex couples for their own employees and most consider the company to be “gay friendly.”

Despite consulting NC state officals regarding the cancellation of the health insurance policies; Blue Cross was still in violation of the Affordable Care Act. The cancellation of the insurance policies is considered illegal under guidelines issued by the U.S. Department of Health and Human Services. According to HHS insurance companies can’t deny coverage to same-sex couples under the Affordable Care Act. Based on the the new laws in the Affordable Care Act there are several nondiscrimination provisions in place for any insurance company that offers coverage through the federal insurance marketplace. Some of the provisions cover things specific things such as nondiscrimination of consumers based on gender identy or sexual orientation.  Blue Cross to offer gay N.C. couples family policies – Local News. Blue Cross stated that their rationale for cancelling the policies was due to advice from the NC Department of Insurance, which defined marriege as a couple of the opposite sex. However the NC Department of Insurance stated that the agency had approved an amendment to it’s policies last year that would have resolved this issue and added that all Blue Cross had to do was file an amendment instead of cancelling the policies.

According to Blue Cross any policies that were cancelled will be restored retroactively. Any new same- sex couples who want to purchase health insurance will be able to buy family coverage which will be effective as of March 1, 2014. However for many couples this news comes a little late. Many couples have already purchased seperate policies due to the fact that they were not allowed to purchase family coverage with Blue Cross. Which leaves them wondering how their situation can be “fixed” at this point.

Blue Cross has also decided it will offer coverage to unmarried couples and small businesses for the first time. It seems like Blue Cross has learned a hard lesson.However it also seems like they are taking the necessary steps to resolve the mess they have made. Hopefully other insurance companies will learn from the mistake that Blue Cross made and won’t follow down the same path. It is difficult enough to find affordable healthcare coverage and navigate all the various options. There’s no need to add additional obstacles to the process.

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