Comments on: Opinion: GP says more NPs not answer – at least not yet

By: Zoo

Mon, 14 Aug 2017 04:25:01 +0000

I didn’t say they aren’t. I said that the claim that NPs have the ‘same scope of practice’ as as GP is incorrect.

If a Masters in Nursing is equivalent to a vocational specialist registration, they should be able to meet the same requirements. Otherwise, it is false to claim that it provides the same skills and knowledge to practice as a neurosurgeon, GP, gastroenterologist, etc

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By: Siân

Mon, 14 Aug 2017 02:44:16 +0000

Zoo, I think you underestimate the NP training pathway. All NZ NPs have a Masters Degree (Health or Nursing). It’s a clinically focused degree with papers in Pathophysiology, Pharmacology, Advanced Assessment and Clinical Decision Making, a Health Research Paper and a few other papers, finishing with a Practicum in Prescribing Practice where they work alongside a Mentor. Having passed this, they then apply to Nursing Council where they are interviewed. We have multiple NPs working in my DHB, both in Primary Health and in the DHB. They are all highly skilled and knowledgeable, and they are exceptional to work with. They are senior nurses with expertise in their chosen area of practice. They do not need to sit medical board exams as they have sat similar for Nursing Council approval for NP status.

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By: Zoo

Sun, 13 Aug 2017 11:35:33 +0000

They *have* fallen back in love with GP. The problem is not that there aren’t enough people wanting to train as GPs, it is simply that there are not enough training positions.

There are specific areas where NPs can fill a gap, but they are not doing the same job. eg Nurse endoscopist do colonoscopies, but they are not gastroenterologists, or trained as such.

No one has addressed any of the points I made.

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By: Joshua Smith

Sat, 12 Aug 2017 14:58:37 +0000

Both Philip and Zoo have suggested that NPs are not a solution because they would be just as hard to entice to rural areas as GPs. Even supposing that is true (though Prof Carryer has above provided reasons why it may not be), I think it misses the much larger issue – that NZ medical graduates have not been choosing general practice for many years. Something like 50% of all GPs are aged over 50, there is a huge gap, it’s a ticking time bomb when all those GPs retire in the next 10-15 years. The point is that NPs *are* happy to work in primary care. They offer a solution to to this much bigger and more fundamental problem. Concerning ourselves over distribution of current GPs to rural areas does not address it. Either that or figure out a way to convince medical grads to fall back in love with GP…

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By: zoo

Sat, 12 Aug 2017 09:37:42 +0000

Unless you are a GP, it is a case of not knowing what you don’t know.

Working with an orthopaedic surgeon doesn’t mean you know what it’s like to be one. Nor does having a nurse practitioner qualification equate to the ‘same scope of practice’ as a general surgeon. Why claim the same ‘scope of practice’ as GPs in primary care; and not orthopaedics, paediatrics, general surgery, or any other clinical speciality?

With regard to challenges of family- it is difficult to staff rural areas with GPs for those reasons, which is Phillips argument. You agree in principle.

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By: Norma Nehren

Fri, 11 Aug 2017 09:42:42 +0000

I think Phillip is way off base reflecting an outdated view of NPs as well as GPs. Phillip’s comments about women and our challenges with family and spouses’ careers….. hmmmm. How old are you anyway?! The majority of GPs under age 45 are female. I’m assuming you must be older than that and maybe don’t have very many female colleagues that you know well or have as friends?
I have 25 years experience working with NPs, PAs and family medicine physicians, 10 years experience working with GPs. Maybe you know something I don’t know? Doubt it.

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By: Zoo

Fri, 11 Aug 2017 06:25:40 +0000

A request to demonstrate competency equates to lack of understanding?

If NPs and GPs are of ‘similar scope’, then the minimum requirement is to pass the GPEP exam.

It would be equivalent to nurse practitioners claiming the ‘same scope of practice’ as an orthopaedic surgeon without fulfilling their fellowship requirements.

The lack of understanding is in what general practitioners do.

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By: Gaye Maree

Thu, 10 Aug 2017 08:38:02 +0000

I respect your knowledge and support of NPs Jenny, you have a far better understanding of the issues than the author of the article and Zoo

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By: Zoo

Thu, 10 Aug 2017 08:07:18 +0000

I’ll repeat my suggestion. If NPs are equivalent in scope to GPs, why not sit the GPEP clinical and written exam to prove it?

Or the equivalent fellowship exams in other specialities?

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By: Philip H.

Tue, 08 Aug 2017 10:54:49 +0000

Thanx. A spirited reply but do I not accept the scope of a rural NP and GP are remotely similar; or that the hours of NP would reflect that of their GP equivalents. How many of these work 60 or even 40 plus hours each week I wonder and for how many years in one community (although this may be a thing in the past for new GPs). So I look forward to seeing this revolution, its consequences and its cost-effectiveness. So why is the world so short of GPs do you think if this is deemed a potential solution? Out of date I may seem to you, but your discipline still has to gain far greater presence and acceptability within the primary care sector and the community. It is not a done deal, it needs context and, of course, as you say, teamwork, mutual understanding and respect.

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