With a shortage of primary care physicians, and the possibility that healthcare reform will exacerbate the problem by increasing the number of people with insurance, many healthcare providers and experts-along with 28 states-are debating how nurse practitioners (NP) fit into the solution.

In Massachusetts, where universal healthcare has already been implemented, a law was passed in 2008 requiring health plans to recognize and reimburse NPs as primary care providers. Other states are considering similar laws. Some NPs with advanced degrees welcome the new role, even asking to be called “doctor” if they hold a doctorate. Supporters believe the role of primary care provider has undergone a significant change and has evolved into a position that involves coordinating care more than anything else, and that this new role suits NP training even better than physicians. (For more thoughts on the topic, check out Takingnote.tcf.org.  They also say that nurse practitioners tend to spend more time with patients, and argue that if they are reimbursed with the same rates, more patients would have access to primary care (currently, Medicare pays NPs 85% of what physicians are paid.) The AP reports that “the health care overhaul law gave nurse midwives, a type of advanced practice nurse, a Medicare raise to 100% of what obstetrician-gynecologists make,” which may lead to a raise for nurse practitioners.

Others, including the American Medical Association, say expanding the role of NP is not a solution to a physician shortage, and suggest the solution is to reward medical students for entering the primary care field. Currently, primary care physicians are some of the lowest-paid physicians, making the field less attractive than high-paying specialties. Others opposed simply argue that physicians are trained differently than NPs, that NPs should remain under physician supervision, and that replacing primary care physicians with NPs endangers patients’ safety (for some more on the argument, check out Fierce Healthcare’s comment section on the article ” Expanding roles of nurse practitioners stir controversy”.

So, nurses, what do you think? Should NPs serve as primary care providers?