Expanded Opportunities In The Medical Profession

Hispanic Times Magazine, Dec, 1999

As medical costs soar, nurse practitioners and physician assistants increasingly find their services in demand.

And as the burgeoning Hispanic population ages, the need for medical personnel to care for them, treat them, and cure them is in short supply.

THE WAY IT WAS

Years ago, such administrative "nursing skills" were nonexistent. In those days, nurses followed doctor's orders, but had no permission to diagnose, advise, or treat patients.

But radical changes have occurred in American health care, which have resulted in a redefinition of nursing roles -- and the creation of advanced-practice nurses such as nurse practitioners.

These changes have been brought about by the financial crisis in the medical profession, which has all but eliminated a large segment of the population from obtaining sound health care. Aside from the underserved populations, there is a factor of aging demographics. Health care has become all but unavailable to millions of Hispanics in this country.

NURSE PRACTITIONERS

Once there was doctoring and nursing -- and otherwise, the field of medical professionals was closed to the rest of the public. Then, in 1965, a Colorado-based pediatrician and a nursing professor trained RNs to treat patients in communities with physician shortages. For the next three decades, nursing schools began offering formal nurse practitioner training.

It was plain and simply a matter of necessity, These skilled medical liaison personnel would minister to patient populations in underserved areas. The program attracted streams of applicants, and the training allowed them an opportunity to expand the scope of their medical knowledge, and provide a more hands-on type-practice with patients, within the realm of their education.

THE SCENE TODAY

Across the country, there are more than 250 nurse practitioner programs in existence today. Graduates of these programs have filled a dire need for primary care where there has been a doctor shortage.

In ten states and Washington, D.C., nurse practitioners have been able to practice independently (rather than under direct physician supervision). However, that situation may change if the American Medical Association rescinds it.

JOB DESCRIPTION

Nurse practitioners need to have all the qualities associated with nursing: nurturing, caring and devotion to service. They are registered nurses who have received a master's degree and clinical training in a specialty such as primary care, neonatal care, acute care of women's health needs. Unlike RNs, they can diagnose, treat and monitor chronic illnesses such as diabetes and high blood pressure. They also can perform, order, and interpret diagnostic studies such as lab work and X-rays.

The job market for these skilled men and women is apparently healthy, both in rural and urban areas. Salaries range from about $47,000 to $74,000. Median income is about $62,000. And, of course, bilingualism is increasingly a plus.

QUALITY APPLICANTS

Men and women who apply to earn their credentials to fill this growing need in the medical profession should be apprised of the responsibilities that come with the job. Individuals who have had experience in social work, teaching and psychology and have volunteered in programs such as the Peace Corps, Vista and planned parenthood, and projects dealing with relating to minority populations are ideal aspirants to be practitioners. Of course, along with almost all health-related jobs, these men and women should be able to handle physical and emotional stress --which can affect patient and practitioner alike.

As the health-care industry struggles to find solutions for the most pressing ailments -- uninsured populations, severe cost-containment cutbacks, and skyrocketing costs involved in all treatment modalities -- it is ever-more essential that nurse practitioners be equipped to provide quality care.

FULFILLING CAREERS

Along with the stresses and demands, for the dedicated men and women who choose this profession -- a high degree of satisfaction prevails.

Managed-car facilities which place more and more time constraints on staff physicians, report that the practitioner liaison method of care is working. With emphasis today on teaching self-care skills such as breast self-examination, the physician may train the staff practitioner to deal directly with the patient in matters of teaching prevention and educating about improving health, such as quitting smoking.

For many nurse practitioners, the greatest reward is the patients themselves. There is satisfaction in finding ways to offer them compassion and guidance, despite time and financial constraints.

PHYSICIAN ASSISTANTS

Like the nurse practitioner profession, the physician assistant career evolved in the 1960's, to help offset the shortage of primary-care physicians in rural areas and inner cities.

It was probably patterned after a fast-track physician training model used during World War II. Dr. Eugene Stead of Duke University opened the first physician assistant training program, Unlike nursing practitioners, whose work force is predominantly female, the physician assistant career attracts an almost equal number of men and women. Their ages range from about 29 years to individuals in their 50's.