sealPurdue News

February 1999

Nurse practitioners reducing costs, expanding care (Lifestyles and Science version)

WEST LAFAYETTE, Ind. -- "Do you want to see the doctor or the nurse practitioner?"

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It's a question more and more Americans are hearing when they call their primary health care provider, and the trend is growing. That's because advanced practice nurses -- those who have education and clinical practice experience beyond that required of a registered nurse -- are taking on new roles that put them on the front line of primary and preventative health care.

The reason goes directly to the bottom line.

"The skyrocketing cost of health care has changed the focus of medical practice to that of health promotion and wellness," explains Sharon Wilkerson, assistant head for graduate studies at Purdue University's School of Nursing. "That's where the advanced practice nurse can really make a difference as a provider -- and the numbers we see indicate that the nation currently needs an additional 100,000 primary care providers to meet desired levels of care."

The American Nursing Association estimates that between 60 percent and 80 percent of primary and preventative care traditionally done by doctors can be handled by a nurse less expensively.

"It's not because the quality of care is different, but because of the basic economic factors involved," Wilkerson says. "Doctors have much higher overhead in terms of equipment and facilities, liability insurance, and the cost of their education."

Nurse practitioners are qualified to handle a wide range of health-related issues, including the diagnosis and treatment of common minor illnesses and injuries. They can prescribe medications, order and interpret lab tests and X-rays, and counsel and educate their patients.

Besides providing a lower-cost alternative to seeing a doctor, nurse practitioners can benefit patients in other ways as well.

"For the most part, a physician's income -- particularly that of a general practitioner -- will fluctuate depending on the number of patients seen," Wilkerson says. "So it's in his or her best interest to treat as many people as possible. But a nurse practitioner receives the same salary no matter how many people are seen, and this can translate into patients spending less time in the waiting room as well as more time for discussion between the nurse and the patient."

Nurse practitioners are one of four types of advanced practice nurses. The others are certified nurse midwife (obstetrics and gynecology), certified registered nurse anesthetist (surgery), and clinical nurse specialist. The clinical nurse specialist usually concentrates on a specific area, such as mental health, cancer care, gerontology or neonatal health.

The most recent national figures available show the average salary for an advanced practice nurse is $52,532 compared to $36,400 for an RN. The field is expected to grow right along with the demand for primary health care providers.

Wilkerson says the field has a number of rewards in addition to higher salaries.

"Advanced practice nurses have a lot more flexibility in terms of the kind of work they do and when they do it," Wilkerson explains. "Many RNs work in the acute care setting of a hospital and only see a patient when there's a crisis. But a nurse practitioner can deliver primary health care across the life span of a patient, and usually during regular office hours."

To help meet the demand for advanced practice nurses, universities such as Purdue have broadened their graduate-level nursing curriculum and made it more accessible using distance education technology such as two-way videoconferencing and the Web.

But even with the additional courses, Wilkerson says there is still a waiting list.

"Because of the very intensive clinics involved, we can only take 15 to 20 students at a time in the traditional classes, and they filled up immediately," Wilkerson says. "Our office fielded at least 62 inquiries before the courses were even advertised."

Similarly, enrollment in a new distance education course in pharmacology is at capacity with 40 students. Plans call for a Web-based nursing research course to be launched this summer that will allow working nurses to take the class on their home computers.

"We're responding to what the industry is telling us it needs," Wilkerson says. "Advanced practice nurses have more versatility in terms of the kinds of care they can provide, and that benefits the patient, the nurse and the employer."

Source: Sharon Wilkerson, (765) 494-4013; e-mail,

Writer: Sharon Bowker, (765) 494-2077; e-mail,

Purdue News Service: (765) 494-2096; e-mail,

As health costs soar, advanced practice nurses are providing more of the routine medical care once handled by doctors. Kellie Lohrman-Kozma is a certified family nurse practitioner in Lafayette, Ind. Here she monitors the fetal heartbeat for a pregnant patient. Nurse practitioners handle a wide range of health-related issues, including the diagnosis and treatment of common minor illnesses and injuries. (News Service photo by David Umberger)
Color photo, electronic transmission, and Web and ftp download available. Photo ID: Wilkerson.njobs1
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