May 2010

Is there a Nurse Practitioner in the House?

Author: Paul deVere | Photographer: Photography By Anne

The figures are staggering. Various studies have concluded that over the next decade, there will be a shortage of 40,000 primary care physicians in the U.S. The shortage is nothing new. For years, even decades, medical schools have been churning out physician specialists in greater and greater numbers. Today, about 90 percent of future physicians opt for specialized medicine rather than primary care. According to a recent CBS television report, primary care is “a field losing out to the better pay, better hours and higher profile of many other specialties.”

Enter the nurse practitioner. More specifically, enter Jennifer Green-Bazzle, MSN-APBC, at Affordable Health Care in Bluffton, an urgent and primary care facility in Sheridan Park. The only thing missing at this medical office is a person with an M.D. after his or her name.

“Nurse practitioners work under their own license, independently,” Bazzle explained. When comparing services offered by a primary care practice run by a medical doctor, Bazzle said, “about the only thing we can’t do is write prescriptions for Schedule 2 drugs. But that’s about it.” (Schedule 2 drugs include such medication as morphine and OxyContin.)

“We can admit to the hospital. We can order MRIs. We can do x-rays, blood work, write prescriptions for blood pressure, diabetes. We get referrals from physicians, specialists. We have our own full-service lab here,” Bazzle said.

Bazzle is certified as an adult nurse practitioner. Her associate, Anna Sharp, is certified as a family nurse practitioner. “Anna gets to see all the kids,” said Bazzle.

Though she doesn’t make the claim, Bazzle may have seen the writing on the wall. According to an article in Time magazine last year (August 3, 2009), “In addition to providing many of the same services [as primary care physicians] less expensively, nurse practitioners offer something else that makes them darlings to health reformers: a focus on patient-centered care and preventive medicine.”

Of the latter part of that quote, Bazzle couldn’t agree more. “Ninety percent of primary care is to prevent things from happening, she said. “We do just good old teaching. You teach people about the medicines, why they went on them, what they’re going to do for them. If you do that, they’re more likely to take them. Instead of just saying, ‘Here’s your prescription,’ we try to engage the patient to be more active in their care. If you know why you’re doing something, you’re more likely to be compliant. Patient education is key.”

As to costs, Medicare reimburses nurse practitioners 80 to 85 percent of what is paid to doctors for the same services. With a small but knowing laugh, Bazzle said, “With each Medicare visit, we’re saving taxpayers money.”

While there were several reasons why a nurse practitioner program began in 1965, the passage of Medicare and Medicaid during that time, combined with the very real fear of inadequate health care for those enrolled due to the shortage of primary care physicians, prompted its creation. Parallels can easily be drawn from today’s news headlines about health care reform and those of 45 years ago.

The reason Bazzle went into nursing in the first place? “I went to nursing school because, well why does every young girl go to nursing school? They want to help people; they have these dreams of having this great profession of helping others. It grew from there,” she explained.

Bazzle grew up on Hilton Head Island in South Forest Beach. She received her undergraduate degree at the University of South Carolina and her masters of nursing at Armstrong Atlantic State University in Savannah. She worked at Hilton Head Hospital in virtually every department. “I ended up in ICU. That’s sort of considered the top job,” she said. But she wasn’t satisfied and, while working, went back to school. “Nurse practitioner was one of the options, and I chose that route. I’m glad I did. I love it,” she said.

According Dr. Helen Taggart, interim head of the Department of Nursing at Armstrong Atlantic State University, while other parts of the country have many private medical offices operated by nurse practitioners, there are not many in the area. Affordable Health Care is the only one in Beaufort County.

Just like other primary care practices in the area, the standard health issues Bazzle sees are obesity, hypertension and cholesterol. “This is the fried chicken belt. What we need is less fried chicken,” she said. Both Bazzle and Sharp said they are also seeing a new medical problem in the area, suffered by both the retired population and young alike. “It’s ‘Wii-itis’ We’re seeing more injuries caused by people overdoing it with the Nintendo Wii,” Sharp said, smiling.

Bazzle said she tries to differentiate her medical facility in several ways. “We don’t overbook. We usually book two patients in an hour so we can take walk-ins. We try to allow the schedule to be a little lighter so we can accommodate those people. We try hard not to make people wait. I’m a good listener, good communicator. We’re very thorough and take a lot of pride in education. We explain things in simple terms so patient isn’t overwhelmed, or doesn’t understand,” she said.

She explained there is another quality Affordable Health Care focuses on: the treatment of the patient as a person. “We treat everybody, from the CEO to a janitor, with the same respect and kindness. It’s just as important up front (waiting room) as it is in the back front office. I treat everybody like they were my brother or sister or mother or father. I ask myself, ‘What would I do if the patient was a family member? That’s how I decide how I’ll treat my patient.”

Of the future of nurse practitioners, Bazzle said the field is growing. “I just returned from a CME (continuing medical education) conference for primary care physicians. Seventy-five per cent were nurse practitioners.”

From the time Bazzle opened her office in 2008, business has steadily grown. “We’re busy,” she said. “When it comes to health care, we’re giving people a choice.”

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