Academy of Chiropractic
MD Referral Program
Program Infrastructure – Novice
William J Owens Jr DC DAAMLP CPC
“If you do NOT have a plan, you are part of someone else’s” – Terrance McKenna
Working with Nurse Practitioners – Introduction
Nurse Practitioners are a valuable part of the healthcare team, in fact they probably see more patients in the primary care settings than many MDs. They are a huge source of potential referrals IF you understand how they work and how to reach out to them.
Wikipedia defines Nurse Practitioners the following way:
“Nurse practitioners (NPs) manage acute and chronic medical conditions, both physical and mental, through history and physical exam and the ordering of diagnostic tests and medical treatments. NPs are qualified to diagnose medical problems, order treatments, perform advanced procedures, prescribe medications, and make referrals for a wide range of acute and chronic medical conditions within their scope of practice. In addition to building upon and expanding their nursing knowledge and skills, the nurse practitioner also learns medicine and uses medical diagnoses and medical treatments in their practice. NPs work in hospitals, private offices, clinics, and nursing homes/long term care facilities. Some nurse practitioners contract out their services for private duty.
In the United States, depending upon the state in which they work, nurse practitioners may or may not be required to practice under the supervision of a physician. In consideration of the shortage of primary care/internal medicine physicians, many states are eliminating “collaborative practice” agreements and nurse practitioners are able to function independently. NPs—particularly in the area of primary care/internal medicine—fulfill a vital need for patient healthcare services, and the nurse practitioner works with physicians, medical/surgical specialists, pharmacists, physical therapists, social workers, occupational therapists, and other healthcare professionals to achieve the best outcomes for patients.
NPs may serve as a patient’s primary healthcare provider and they may treat patients of all ages depending upon their specialty. With commensurate education and experience, nurse practitioners may specialize in areas such as cardiology, dermatology, oncology, pain management, surgical services, orthopedics, women’s health, and other specialties. Similar to all healthcare professions, the core philosophy of the nurse practitioner role is individualized care that focuses on a patient’s medical issues as well as the effects of illness on the life of a patient and his or her family. NPs tend to concentrate on a holistic approach to patient care, and they emphasize health promotion, patient education/counseling, and disease prevention. The main classifications of nurse practitioners are: adult (ANP); acute care (ACNP); gerontological (GNP); family (FNP); pediatric (PNP); neonatal (NNP); and psychiatric-mental health (PMHNP). Adult-gerontology primary care nurse practitioner (AGPCNP) is a classification that has recently evolved.
In addition to providing a wide range of healthcare services, nurse practitioners may conduct research, teach, and are often active in patient advocacy and in the development of healthcare policy at the local, state, and national level.
Many times the NP is seeing the spine cases since the MD generally does not want to get involved with those patients. NPs are often VERY open to chiropractic care and tend to be very conservative providers. When you are reaching out to the MD, I would ALWAYS make time to talk with the NPs in the office, most often those are the providers that I spend the most time with both professionally and socially. They are also present at a high level in the Emergency Departments. One thing to think about is they are a tight knit group and once you know 1 or 2 it is EASY to be introduced to 100s more…JUST ASK…There are many in the program that have presented to the local NP Association – they have monthly meetings like chiropractors, PTs and MDs – they are always looking for sponsors. I have the presentation materials all together for you, all you need to do is contact the organization, tell them you would like to sponsor a meeting and then email me…I will help you through it.