Abstract In Reply.— Baggs asks if nurse practitioners staffing the health promotion clinic program in our trial1 partly explains its better prevention outcomes, compared with results for the two clinic-integrated models directed at physicians or patients.The high quality of patient care by nurse practitioners and their contribution to ambulatory care are well documented in many studies. That issue has been laid to rest. In this study, Veterans Administration patients voluntarily attended the health promotion clinic program and did not know in advance who staffed the clinic. Their motivation was a personal interest in preventive services unavailable at their usual clinic vist. After attending the program, however, they said that nurse practitioners "were competent," "allowed me to ask questions," and "conveyed a sense of respect" (unpublished data). Undoubtedly, this expressed satisfaction was a major factor affecting decisions to return for annual re-examinations at such a high (90%) rate.We used References 1. Belcher DW. Implementing preventive services: success and failure in an outpatient trial . Arch Intern Med. 1990;150:2533-2541.Crossref 2. Carter A, Thompson RS, Bourdeau RV. A clinically effective breast screening program can be cost-effective too . prev Med. 1987;16:19-34.Crossref 3. Hall JA, Palmer RH, Orav EJ, et al. Performance quailty, gender, and professional role: a study of physicians and nonphysicians in 16 ambulatory care practices . Med Care. 1990;28:489-501.Crossref 4. Belcher DW, Berg AO, Inui TS. Practical approaches to providing better preventive care: are physicians a problem or a solution? Am J prev Med. 1988;4( (suppl) ):27-48.
Archives of Internal Medicine – American Medical Association
Published: Dec 1, 1991
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