AAFP Report on Transforming Primary Care Raises Scope-of-Practice Concerns among Nursing Groups

The American Academy of Family Physicians (AAFP) has released a report on primary care reaffirming its support of the physician-led care team as the best method to transform primary care delivery. According to AAFP, this team is central to the patient-centered medical home (PCMH) model of care, which has been demonstrated to improve quality of care, care coordination, and cost-effectiveness in numerous large public and private demonstrations (see the September 21, 2012, Physician Practice E-News). AAFP’s report has raised some controversy among nursing groups by stating that the shortage of primary care providers cannot be addressed by replacing physicians with independently practicing nurse practitioners (NPs), because the length of training and the competencies taught to the clinicians are not the same.