Research Proposal Exploring the Differences in Patients’ Satisfaction with Primary Care Provided by Nurse Practitioners and General Practitioners Your Name Your University Introduction Nowadays it is acknowledged that health systems of many countries experience a crisis caused by such challenges as population ageing, professional skills shortages, patients’ rising expectations, necessity of quality improvement concurrently with cost reduction…
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A nurse practitioner is a qualified nurse who has additional education and specialization in some particular area. In the USA, NPs must have a master’s degree minimum and 500 to 1,000 hours of training; the education of NPs is guided by the American Association of Colleges of Nursing (Rough, 2009). Traditionally, NPs work as doctor supplements providing services which extend services provided by GPs. Now more and more NPs start working as doctor substitutes, having rights to independently provide a wide range of services, usually provided by GPs. The aim of such shift of the NPs role mainly is to address current GPs shortage and to reduce cost of health care services (Dierick-van Daele et al., 2008). The doctor-nurse substitution is much debated in professional literature and in the press; a number of important problems related to permissibility, practicability and efficiency of this innovation have been studied during the last decade. This document presents a proposal for a piece of research which is aimed to explore the differences between patients’ satisfaction with services provided by NPs in comparison with patients’ satisfaction with services provided by GPs in primary care. In addition, we intend to explore factors influencing on the differences in patients’ satisfaction. We hope that our study will promote an effective process of NPs’ and GPs’ skill mix and substitution and make a contribution in positive changes in the US health system at a whole. Problem Statement The tendency to hire nurse practitioners as a substitute for doctors has intensified during last years. Rough (2009, para.4) cites the American Academy of Nurse Practitioners (AANP), which estimated that from 2004 to 2009 the number of NPs in the United States has increased by about 40 per cent, amounting to 125,000. Dierick-van Daele et al. (2008) consider four main reasons of the current demand for NPs: “(1) to overcome a shortage of doctors in particular settings; (2) to improve the quality of care; (3) to advance the career of nurses; and (4) to lower health care costs by employing the ‘lowest cost provider’” (p.481). Many experts agree that today’s nurses may work well not only as doctor supplements, but also as doctor substitutes, in particular in primary care. According to the recent research, from 25% to 70% of GP’s work might be successfully fulfilled by nurses (Laurant, Reeves, Hermens, Braspenning, Grol and Sibbald, 2007). This includes a wide range of activity from diagnosing, testing and prescribing medication to health promotion and routine management of chronic diseases. In several countries and the US states the shift in NPs’ status is supported by legislation, allowing NPs to work independently in various health care fields, including such specific ones as family practice, psychiatry, women health, pediatrics etc. However, there is a certain controversy in the medical community, as some experts argue about significant risks related to the independent work of NPs in primary care, such as misdiagnosis or inappropriate treatment. For example, the American Academy of Nurse Practitioners and the American Medical Association hold the opinion that NPs should work only in collaboration with GPs (Rough, 2009). Young
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