Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.

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The Strain of Increasing Patient Populations on Primary Care

One stressor affecting healthcare on a national level is increasing strain that is being placed on primary care providers. In an article published in the journal “Managed Care” titled Primary Care Continues to Feel the Strain (2012), the authors explain that providers in the primary care setting

currently only spend 15 minutes on average with each patient. With the increases in patient needs, these practices simply cannot handle taking on more patients. The demands placed on providers to incorporate preventative care into the treatment of a patient’s current illness or chronic condition are

making it difficult for providers to maintain quality care in such a short visit with a patient.

My current work setting is a primary care office, that provides care to patients on a sliding fee which based on income. We work to serve the uninsured and underinsured population of Eastern Idaho. With five providers currently seeing an average of forty patients a day each, our office is feeling

the strain of increasing patient populations. This strain not only affects the providers, but has added strain to the nursing staff, reception staff and medical billers.

Currently our providers each have their own patient population, where for primary care needs, the patient only sees the one provider. A patient needing refills on his metformin or lisinopril can only be seen by the provider that prescribed that medication currently. The problem this is creating is

the inability to schedule these patients for a follow up before they are out of refills due to a provider’s schedule being booked for weeks out.

The solution that has been implemented to aid in this problem is the use of nursing teams. Each provider has his or her own team of nurses. As the lead nurse for my physician, patient phone calls, questions and refill requests come to me first. We also have a care coordinator that helps to

manage patient referrals and making sure imaging appointments are made and reports are uploaded to the patient chart. In chapter 3 of the course text, it is established that successful teams use each member’s strengths to benefit of the team and to the quality of patient care (Marshall & Broome,

2017).

Our success with these small collaborative teams is the main reason the use of primary care collaboration is being considered. This involves the use of a primary care team, instead of a single provider. Each team including a physician and one or two other providers (either nurse practitioners or

physician assistants). A literature review performed by Norful, de Jacq, Carlino &Poghosyan (2018) identified that in order for this type of arrangement to be successful, the members of the primary care team would be required to not only communicate and respect each other’s medial knowledge

and ability, but also develop a way to align their clinical methods and beliefs about medical care.

References

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.

Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse practitioner–physician comanagement: A theoretical model to alleviate primary care strain. Annals of Family Medicine, 16(3), 250–256. doi:10.1370/afm.2230

Primary care continues to feel the strain. (2012). Managed Care (Langhorne, Pa.), 21(2), 25. Retrieved from https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=mnh&AN=22396978&site=eds-live&scope=site

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