By Tom Bush

Guest columnist

We have all heard reports about the impending primary care clinician shortage -- within the next few years, there will be too few primary care doctors to treat the patient population. And with health care reform legislation circulating on Capitol Hill, there will likely be an enormous influx of newly insured patients entering the health care system.

Have you stopped to wonder who is qualified and capable to step in and fill the gap of access to health care?

The answer is: nurse practitioners, and for North Carolina, this is a very good thing. According to the North Carolina Institute of Medicine (NCIOM), the number of nurse practitioners (NPs) in the state has skyrocketed by 231 percent since 1990. Growth and utilization of the NP community has improved health care access for thousands of citizens in our state. These providers can augment their contributions to health care when hundreds of thousands of previously uninsured N.C. citizens begin making appointments for check ups and other routine care services.

This change comes at a time of growing recognition that greater use of primary care services and less reliance on specialty services can lead to better health outcomes at lower cost. Historically, internists, family medicine doctors and pediatricians have provided this type of care, but fewer and fewer new medical school graduates are entering primary care. In fact, some medical schools are even eliminating primary care specialties from their residency training programs.

NPs -- master's or doctorally prepared nurses -- have served North Carolina for decades. At more than 3,000 strong, they are ready to offer their expertise to even more patients by diagnosing diseases, identifying barriers to care and developing individualized plans of treatment.

In fact, extensive research validates the safety, efficacy and cost effectiveness of care that NPs provide. NPs help close the gap between evidence-based recommendations and clinical practice by developing plans of care that are sensitive to the strengths, limitations and goals of each patient. Nurses are educated to consider the physical, emotional and spiritual facets of the human condition, and NPs focus much of their energy on health promotion and disease prevention. This is a fundamental reason why NPs are rated highly on patient satisfaction surveys.

The predicted primary care physician shortage is coming when increased demand for health care services is almost certain. Any comprehensive plan to meet the needs of our citizens must include provisions to expand the number of NPs in North Carolina.

Calls for reform in North Carolina should focus on solutions to the larger problem of consumers' access to safe, cost-efficient care. I am hopeful that we can continue to build on the strengths of all clinical disciplines, celebrate the differences and point toward models of collaboration that serve our citizens well.

As a practicing NP in North Carolina, I stand ready with my NP colleagues to tackle the growing shortage of primary care providers. We must work toward developing a long-term solution that will benefit the health and well being of our citizens for decades to come.

Tom Bush is chairman of the North Carolina Nurses Association Council of Nurse Practitioners and clinical assistant professor at the University of North Carolina at Chapel Hill Schools of Nursing and Medicine.