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they said that nurse practitioners "were competent," "allowed me to ask questions," and "conveyed a sense of respect" (unpublished data).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
Belcher DW. Health Promotion and Nurses-Reply. Arch Intern Med. 1991;151(12):2484–2485. doi:10.1001/archinte.1991.00400120112030
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