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March 16, 1994

Nurse Practitioner Redux

JAMA. 1994;271(11):868-871. doi:10.1001/jama.1994.03510350078041

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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