sealPurdue News

February 1999

Nurse practitioners reducing costs, expanding careers (Business 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."

Financial beneficiaries of the nurse-practitioner trend include the health care organization, and indirectly, consumers, according to Priya Rajagopalan, visiting assistant professor of economics at Purdue.

"The patient or their insurance company will pay the same amount for an office visit whether they see the doctor or the nurse practitioner, so the patient won't see the savings on the front end," she says. "But by containing its costs on services for minor illnesses and injuries, the provider can use the savings to cross-subsidize other programs to keep them more affordable."

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.

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."

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.

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.

"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."

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

Priya Rajagopalan, (765) 494-4436; 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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