Doctor-nurse practitioner collaboration can be fruitful

A team of health care professionals calls for the two to work better together.

By Damon Adams, AMNews staff. Oct. 7, 2002.

When David Mehr, MD, sees patients in the clinic or nursing home, nurse practitioner Melba Hall stands ready to help. The Missouri family physician views Hall as a vital partner to providing quality health care.

"Melba and I have a very strong collaborative relationship," said Dr. Mehr, an associate professor in family and community medicine at the University of Missouri-Columbia. "She contacts me about problems, and I contact her. We alternate visits on patients with diabetes. If I'm not in the office, she will see some of my patients."

A recent analysis of the work relationship between doctors and nurse practitioners said such collaborative efforts can improve patient care. In an article in the September/October issue of Health Affairs, a team of family physicians and nurse educators called for studying, training and deploying a collaborative, integrated work force.

"We need to break out of these turf wars and do some good research and planning on how these work forces can work together. If patient-centered care is the real goal, we've got to learn as physicians to work with nurse practitioners," said Bob Phillips Jr., MD, lead author and assistant director of the Robert Graham Center: Policy Studies in Family Practice and Primary Care in Washington, D.C.

Dr. Phillips, two others from the Graham center and two nurse educators looked at the relationship. In their analysis of published articles, the authors trace nurse practitioners from their start in 1965 to their role in health care today. They said nurse practitioners have moved toward more independent decision-making, but physician and nursing organizations have sparred over practice control and reimbursement. [...]