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Independent practice














Assessing clients
Synthesizing & analyzing data, understanding & applying nursing
principles at an advanced level
Providing expert teaching & guidance
Working effectively with clients, families, health care team
Managing clients’ physical & psycho-social health-illness
Utilizing research skills
Analyzing multiple sources of data, differential diagnosis, selecting
appropriate treatment
Independent decisions in solving complex client care problems
Diagnosing, prescribing, administering & dispensing therapeutic
measures

Recognizing limits of knowledge & experience, planning
for situations beyond expertise, consulting with or
referring to other health care providers as appropriate










NPs earned the right to practice independent
of physicians in ME in the mid-1990s
NP must complete at least 24 months of
supervised work
NPs can now be credentialed as participating
providers
NPs can be primary care providers in
managed care organizations
A new grad can be supervised by another NP
who is independently licensed.
Physician supervision required

Physician supervision not required


1088 NPs in ME in 2012



Most are independently licensed



Fewer than 50 practice independently




Distribution of NPs and primary care similar
Majority of NPs in ME in Primary Care
From the ME NP Association web site:
◦ Overall 25% of NPs in rural areas of ME
◦ In primary care about 40% rural (most in FM)





Rural distribution of NPs almost identical to
FPs
NPs, PAs and Physicians are all leaving
primary care at about the same rate (AHRQ
and Robert Graham Center data)
120000
100000
80000

52%
TOTAL

0
NPs

IN PRIMARY CARE

30,402

43%

70,383

20000

55,625

40000

106,073

60000

PAs

Data from 2010 National Provider Identifier File

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Chamberlain.aafp slc 2013

  • 2.           Assessing clients Synthesizing & analyzing data, understanding & applying nursing principles at an advanced level Providing expert teaching & guidance Working effectively with clients, families, health care team Managing clients’ physical & psycho-social health-illness Utilizing research skills Analyzing multiple sources of data, differential diagnosis, selecting appropriate treatment Independent decisions in solving complex client care problems Diagnosing, prescribing, administering & dispensing therapeutic measures Recognizing limits of knowledge & experience, planning for situations beyond expertise, consulting with or referring to other health care providers as appropriate
  • 3.      NPs earned the right to practice independent of physicians in ME in the mid-1990s NP must complete at least 24 months of supervised work NPs can now be credentialed as participating providers NPs can be primary care providers in managed care organizations A new grad can be supervised by another NP who is independently licensed.
  • 4.
  • 5. Physician supervision required Physician supervision not required
  • 6.  1088 NPs in ME in 2012  Most are independently licensed  Fewer than 50 practice independently
  • 7.    Distribution of NPs and primary care similar Majority of NPs in ME in Primary Care From the ME NP Association web site: ◦ Overall 25% of NPs in rural areas of ME ◦ In primary care about 40% rural (most in FM)   Rural distribution of NPs almost identical to FPs NPs, PAs and Physicians are all leaving primary care at about the same rate (AHRQ and Robert Graham Center data)
  • 8.