In July 2010, PRNewswire published an announcement by the U.S. Department of Health and Human Services Secretary Kathleen Sebelius of $15,000,000 in federal funding for the operation of 10 nurse-managed health centers. The centers would be used in the education and training of nurse practitioners. Such centers are staffed by nurse practitioners and provide comprehensive primary health care services to residents of medically underserved communities.

Advanced preparation of nurse practitioners, which takes place at the graduate level (masters, postmasters, and doctoral degrees), employs a strong curriculum that adds to the already present knowledge and skills of practicing professional nurses. These programs of study prepare fully accountable clinicians to provide care to a range of conditions and severity of illnesses.

However, physicians groups are not necessarily supportive. For example, the American College of Physicians published a position paper in 2009 that included the following:

Position 1: Physicians and nurse practitioners complete training with different levels of knowledge, skills, and abilities that, although not equivalent, are complementary. As trained health care professionals, physicians, and nurse practitioners share a commitment to providing high-quality care. However, physicians are often the most appropriate health care professional for many patients.

Position 2: In the patient-centered medical home (PCMH) model, care for patients is best served by a multidisciplinary team where the clinical team is led by a physician.

1. What types of patients would benefit most from a physician and from a nurse practitioner?

2. Why is the shortage of primary care providers more severe in some regions?

3. What types of barriers and difficulties exist for nurse practitionerled practices? Will the new grant program help solve any of these barriers?