Intended for healthcare professionals

Rapid response to:

Primary Care

Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors

BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7341.819 (Published 06 April 2002) Cite this as: BMJ 2002;324:819

Rapid Response:

Re: Re: Can nurse practitioners provide equivalent care to G.P.s

Among ourselves, most of us will complain about aspects of our education which seem completely irrelevant to our daily clinical practice.

Yet those physicians who disapprove of physician extenders point to the length of their own training as if it had all been focused, clinically important content that they use everyday in the provision of safe patient care. And regarding the presumptive benefit of advanced training in basic sciences: any physician who has been in practice for more than 10 years or so should examine a recent HIGH SCHOOL advanced biology text if they care to be made humble about the extent of their expertise in current, basic biology. The competencies needed for effective primary care can be taught and acquired via many different pathways. In fact, one might question whether some American medical schools any longer teach some of these skills.

Physician colleagues complain that many young physicans lack bedside diagnostic skills (research confirms this). It is the competencies that we should debate, not the pathways one takes to acquire them. A serious debate about the scope and definition of those competencies and about effective teaching strategies could benefit future patients. Also needed is research into best practice models for collaborative care using multidisciplinary teams.

Competing interests:   In so far as I teach nurse practitioners, I could be said to have a competing interest.

Competing interests: No competing interests

02 October 2003
Phylls du Mont
Assistant Professor
University of Tennessee, Knoxville, TN, 37931