Have Nurse Practitioners Reached a Tipping Point?: Interview of a Panel of NP Thought Leaders

Peter I. Buerhaus, PhD, RN, FAAN


Nurs Econ. 2010;28(5):346-349. 

In This Article

Abstract and Introduction


Throughout the debate over health care reform, health policymakers, health workforce planners, and members of Congress acknowledged concerns over the adequacy of the health care workforce, particularly the current and projected shortfalls in the number of primary care physicians (Donelan, Buerhaus, DesRoches, & Burke, 2010). Because millions of Americans are expected to gain health insurance in the coming years, the media's interest in the health workforce has increased and has even focused on whether restrictive state practice acts are constraining opportunities for nurse practitioners (NPs) to fill the gap in primary care (Johnson, 2010). There has also been a flurry of articles published in the health policy literature describing the roles, education, clinical outcomes, and challenges confronting an expansion of NP practice (Cunningham, 2010; Everett, Schumacher, Wright, & Smith, 2009; Naylor & Kurtzman, 2010; Pohl, Hanson, Newland, & Cronenwitt, 2010).

With this increased attention to NPs, I wanted to explore the current state and future outlook for NPs. For these insights I turned to Dr. Bonnie Pilon, senior associate dean for practice at Vanderbilt University School of Nursing. Dr. Pilon convinced me that our interview would be enriched if it included other NP thought leaders. With this urging, I am delighted the following agreed to share their thoughts about a range of issues facing NPs: Christina Esperat, professor and associate dean for practice and research at Texas Tech University Health Sciences Center, School of Nursing; Tine Hansen-Turton, executive director of the National Nursing Centers Consortium; Amy J. Barton, professor and associate dean for clinical and community affairs, University of Colorado College of Nursing; and Charlene Hanson, professor emerita and family nurse practitioner at Georgia Southern University School of Nursing. Knowing his interest in health policy and the health care workforce, I also invited John Iglehart to join the interview. John is the founding editor of the health policy journal, Health Affairs and, for more than a quarter decade, has served as the national correspondent for the New England Journal of Medicine. While I recognize other advanced practice nurses provide primary care services, particularly certified nurse midwives, the focus of this interview was on NPs. Because of their large numbers and the existing educational capacity to produce additional NPs, NPs have the greatest potential to fill gaps in the primary care workforce in the United States.