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Use of nurse practitioners could fill healthcare gap

Your article about community health centers, "The patients are in: Newly insured keeping medical centers busy and growing" (Globe NorthWest, Sept. 13) by Robert Preer, left out the obvious solution to the physician-shortage problem: Use nurse practitioners and other advanced practice nurses to fill in the gaps.

Nurse practitioners are the invisible providers in healthcare. They have worked tirelessly as primary-care providers of underserved urban and rural patients in neighborhood health centers since their inception in the 1960s. Healthcare plans, such as Harvard Vanguard and many private practices in the area, have always employed nurse practitioners extensively on teams with physicians to provide primary care as well as care to chronically ill patients, but do not list them as providers.

Nurse practitioners are the perfect solution to this crisis, since they are educated to work with families in a holistic way to meet complex needs in interdisciplinary settings. Their focus is on health promotion, prevention of disease, and management of chronic conditions along with illness care, rather than just on the treatment of medical conditions, as is the norm in the "medical model."

The 4,000 nurse practitioners in Massachusetts are now seeking to gain recognition as primary-care providers so that they can be listed under their own name for the services they already provide. It is time to use all of our resources to fill healthcare shortages and make visible the efforts of nurse practitioners and other advanced practice nurses.

Joyce Pulcini
Pediatric nurse practitioner and associate professor at Boston College's Connell School of Nursing

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