>Robert Bracchi wrote:
>>
>> Question:
>> How long will it be before there is a study showing that Nurse Practitioners
>> are cheaper, do less investigations,do less referrals and are prefered by
>> patients than the average GP?
>>
>> Answer?
>>
>> Robert Bracchi
>
>An interesting question.
>
>There was a famous randomised trial in Canada in the early 1970s
>(Spitzer WO, et al. The Burlington randomized trial of the nurse
>practitioner. (N Engl J Med, 1974 Jan 31)
>
Yes it was widely quoted as a "scientific" study. However it did not lead
to the implementation of nurse pracitioners in the province, since the real
determinants and the final call has to be political. (And as a sometime
elected politician, I believe that there is no alternative to political
decisions regarding the allocation and organization of resources.)
If the perception of care is that it is all about doing procedures, if the
payment is fee for service and if the methodology of studies is on cost
effectiveness of procedures, it is quite likely that alternative providers
will come out well. If the process is predominantly information exchange
and processing (which I and presumably most participants on this forum
believe) a different approach to studies is needed.
Sure, I like to work in a team approach, involving nurses etc. I am just
not convinced that this can be justified by scientific studies. It's
political, therefore we need more doctor politians.
Bob Frankford >
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