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Nurse Practitioners

Patients seeking treatment may be offered an appointment with a nurse practitioner (NP) on staff. NPs often work in medium and larger-scale offices, particularly in general and internal medicine.

What a nurse practitioner does

Nurse practitioners are more than registered professional nurses; they are rapidly becoming the healthcare provider of choice in the United States.

The profession emerged in 1965, and today more than 150,000 NPs work in diverse settings like medical offices, school clinics, hospitals, urgent care facilities, community health centers, emergency rooms and workplace clinics. An NP has many of the same responsibilities as a physician. On any given day, a doctor might be performing a well patient physical while the practice's NP completes one in the adjoining exam room.

These nurses have specialized training to check an individual's health and diagnose medical conditions. They manage health problems by developing treatment plans and promoting a healthy lifestyle. One of their most important functions is collaborating with patients, their families and other healthcare providers to share information.

NPs can practice within the boundaries of the Nursing Practice Act in their respective states. In metropolitan areas, they sometimes own their own practices.

Why see a nurse practitioner?

In many cases, patients opt to see an NP instead of their regular doctor. Most commonly, they need treatment right away, or at least sooner than the next available doctor's appointment. In some practices, NPs see patients before a formal doctor's examination. They coordinate medications and are responsible for administering all immunizations. NPs can write prescriptions in every state, and nearly 90 percent of NPs are trained in primary care, according to the American Academy of Nurse Practitioners (AANP).

In an increasing number of cases, NPs are a patient's primary healthcare provider, coordinating and managing office care, transitional care and home care. They order laboratory tests, give patients referrals to specialists and make sure all the practices involved share information about the person. In both inpatient and outpatient settings, they're often in charge of intravenous (IV) therapy for certain illnesses.

Patients also see NPs for counseling. These nurses educate people on disease prevention and lifestyle choices and are often the practitioner in charge when an on-the-job injury occurs. NPs also prescribe medication, and some work in research or administration.

These professional nurses fill the shortage of primary care physicians in the United States by providing high-quality, patient-centered care. They focus on health promotion, disease prevention, health education and counseling. The preventive care they offer, whether over the telephone or in person, can lower the cost of healthcare for patients.

A medical practice typically bills health insurance under a physician's name for services an NP provides. Some NPs with their own practices can bill insurance directly as care providers. Regulations vary per state.

Requirements for a nurse practitioner

All NPs have earned a master's or doctoral degree, in addition to clinical training beyond that of a registered nurse. In all states and the District of Columbia, they need a license to practice.

The path to becoming an NP starts with becoming licensed as a registered nurse. While earning a graduate degree, prospective nurses must choose at least one clinical specialty. The last required credential is national board certification in one of these practice areas: family, pediatric, neonatal, adult, geriatric, psychiatric, acute care or women's health.

While earning an advanced degree, nurses completing the requirements to become an NP can also choose subspecialty areas for research and clinical practice, such as allergy and immunology, cardiovascular medicine, dermatology and endocrinology.

At least five professional organizations have boards that certify NPs, but not all of them offer certification exams in all practice areas. The AANP, which is one of the largest, offers competency-based exams for certification in adult, geriatric and family medicine, with the opportunity to recertify every five years.

When choosing a practitioner, the AANP maintains an NP locator. Prospective patients or family members can look up NPs according to distance from a given location, practice area and age groups served. The locator also shows where the NP has hospital privileges, office hours and types of health insurance accepted. You can also review member recommendations and ratings on Angie's List, where you can verify their qualifications, education, continuing education, accepted insurance plans and affiliated hospitals.