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Nurse Practitioner Redux

Catherine D. DeAngelis, MD
JAMA. 1994;271(11):868-871. doi:10.1001/jama.1994.03510350078041.
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FOR those of us who were involved with the early nurse practitioner (NP) movement, the recent expansive embracing of advanced practice nurses is at once gratifying and thought provoking. It will be interesting to see if history repeats itself and NPs will continue to provide only a small proportion of primary care to Americans. I hope this will not be the case and that NPs soon will play a significant role in primary care. To assure the success of NPs, we might learn some valuable lessons from history.

History  As a nurse who had gone on to medical school and training in general pediatrics, I held the firm belief that the maldistribution of health care in this country could be resolved if nurses, with additional clinical training, would work with physicians as teams providing primary care. The work of Drs Henry K. Silver (a physician) and Loretta C. Ford (a


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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