Healthcare in the Shadows

Nurse Practitioners at Rockefeller Center

Posted by on Thursday, October 29, 2015 in News.

Columbia Advanced Practice Nurse Associates offer primary, intermediate and walk in care in midtown Manhattan just steps from the iconic Rockefeller Center and around the corner from Radio City Music Hall.  The name on their door says Columbia Doctors but don’t be fooled:  the care delivered inside is all nurse practitioner managed and delivered to a younger population with relatively higher incomes and the patients are all insured.  The misleading name is the practice’s billing organization used to be sure they can collect payment for the care they deliver. Quite a contrast to the many safety net clinics I’ve visited this year but of course, advanced practice nurses are equally qualified to care for paying patients and help those patients achieve a healthier life.

Nadia Elgoghail, Stephen Ferrara, & Diane Hernandez at Columbia School of Nursing's Midtown Clinic

Columbia School of Nursing will be opening a new clinic in Spring 2016 in Washington Heights, a much bigger site, where they will significantly increase access for patients with Medicaid. Many of those patients do not have a primary care healthcare home and the Columbia group will be working with their medical center to receive these patients as they transition out of the ED or inpatient care, hopefully decreasing the number who bounce back and forth from community to acute care. As US healthcare changes its focus to prevention, the emphasis on stabilizing patients within their communities and healthcare homes is a critical goal for all healthcare systems nationally. These nurse practitioners, led by Associate Dean Dr. Stephen Ferrara, are poised to play a pivotal role within the Columbia University healthcare system, helping their patients manage chronic and acute illnesses, including mental health challenges.

There’s good news in New York state for scope of practice, too.  On January 1, 2015, the Nurse Practice Modernization Act went into effect.  This law removes most restrictions to practice for all nurse practitioners with 3600 hours or more of clinical experience.  Removing such restrictions frees up dollars (it costs money for NPs to “buy” supervision from physicians in states with supervision rules) and time to spend on patient care.  Given that New York is a Medicaid expansion state and that Metropolitan New York City has a shortage of accessible primary care providers, removing unnecessary NP practice restrictions translates into good news for patients who need care.

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