>The question
> now is do we need them? To which I would answer a loud "yes".
> We need them to relieve the ever increasing demand and workload.
> The danger is that too much work will be delegated leaving the
> GP with a more uncertain role. That is why the core services
> issue is so dangerous. I am quite against the concept. GPs
> will paint themselves into a corner.
I entrely agree Doug but there is no likeliehood that the GP will lose
his role. It is far more likely that the GP role can develop it into
whatever the individual GP wishes it to be.The primary care team will be
flexible enough to allow that. Indeed the team can flex to change roles
with time, allowing a richer varied and attractive environment within
which to work.
Core services are a potential noose into which we happily put our
necks. As we define ourselves more tightly other providers will look at
the non-core services and thankfully tender for their provision. We
should value ourselves much higher than that. Nurse Practitioners
provide the opportunity to provide a wider primary care service to meet
the needs of our patients. If you wish to test the acceptability of
nurse practitioners ask the patients their opinion of nurses and see
what they say.
Keep in mind the Nurse Practitioner is not a name to cover a good
practice nurse but implies a *qualification* which allows that
practitioner to work independently of the doctor, not in competition but
alongside. The skills of the doctor and the nurse move in different
directions but similar areas. This is not an attempt to create
quasi-doctors but simply to recognise that there is more work than we
can all cope with at present.
Many of the roles that we have lost to the *specialist * at the
hospital can be regained with the assistance of the time generated by
the nurse practitioners. If that is not your wish then it can allow you
to recover general practice as it used to be, horse drawn carriage and
all. If that is what the patients want. The style of general practice
will change and will not suit all but the workload pressures and patient
demand is shifting the tide against the traditionalist approach.
I have no desire to work as a salaried practitioner to escape the
pressures but would wish to retain my independence. If that means
easing the interminable workload by releasing the potential of the nursing
team then so be it.
Colin J Browne The Black Country Family Practice
Queens Rd, Tipton, West Midlands, England
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|