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Nurse-Led Primary Care Remains Controversial

Lack of national standards undermines advanced nurse practitioners' credibility

FRIDAY, Sept. 5 (HealthDay News) -- Nurse-led primary health care is the logical conclusion to a trend already well under way, according to a Head to Head article published online Sept. 4 in BMJ, while a companion article argues that nurse-led primary care would restrict patients' choice and would be a backward step.

Bonnie Sibbald, Ph.D., of the University of Manchester in the United Kingdom, argues that nurses should be acknowledged as the true frontline providers of primary health care, and writes that the primary care physician's role should shift to that of consultant treating referrals from nurses.

However, Rhona Knight, a general practitioner in Leicester, U.K., writes that the extensive and comprehensive training that doctors undergo equips them with a skills and knowledge base that cannot be substituted with a nurse's skills, particularly as advanced nurse practitioner training lacks nationally agreed standards.

"As for team leadership, moving to a purely nurse-led service would be a backward step in a climate of increasing multi-professional working, where leadership teams benefit from many perspectives," Knight writes. "The concept of nurse-led primary care, driven by cost-cutting agendas rather than adequate evidence, devalues medical training and the complex expertise of the general practitioner. Restricting patient choice, it also undermines the importance of nurses in delivering their unique contribution to primary health care."

Abstract - Sibbald
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Abstract - Knight
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