Dr. Judith Chamberlain's 2013 SLC Presentation
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  • 1. Independent practice
  • 2.           Assessing clients Synthesizing & analyzing data, understanding & applying nursing principles at an advanced level Providing expert teaching & guidance Working effectively with clients, families, health care team Managing clients’ physical & psycho-social health-illness Utilizing research skills Analyzing multiple sources of data, differential diagnosis, selecting appropriate treatment Independent decisions in solving complex client care problems Diagnosing, prescribing, administering & dispensing therapeutic measures Recognizing limits of knowledge & experience, planning for situations beyond expertise, consulting with or referring to other health care providers as appropriate
  • 3.      NPs earned the right to practice independent of physicians in ME in the mid-1990s NP must complete at least 24 months of supervised work NPs can now be credentialed as participating providers NPs can be primary care providers in managed care organizations A new grad can be supervised by another NP who is independently licensed.
  • 4. Physician supervision required Physician supervision not required
  • 5.  1088 NPs in ME in 2012  Most are independently licensed  Fewer than 50 practice independently
  • 6.    Distribution of NPs and primary care similar Majority of NPs in ME in Primary Care From the ME NP Association web site: ◦ Overall 25% of NPs in rural areas of ME ◦ In primary care about 40% rural (most in FM)   Rural distribution of NPs almost identical to FPs NPs, PAs and Physicians are all leaving primary care at about the same rate (AHRQ and Robert Graham Center data)
  • 7. 120000 100000 80000 52% TOTAL 0 NPs IN PRIMARY CARE 30,402 43% 70,383 20000 55,625 40000 106,073 60000 PAs Data from 2010 National Provider Identifier File