| Nurse practitioners have been providing primary care for patients in a variety of settings for over 40 years. The role of nurse practitioners has expanded and includes prescriptive authority. At the same time, nurse practitioners in independent practice has been limited in some states by legislative restrictions and other barriers. The shortage of primary care physicians is expected to reach 200,000 by 2020 (Vestal, 2013). It is estimated that out of 186,000 nurse practitioners in the United States only about 6,000 are in independent practice (Aizenman, 2013). The critical physician shortage is expected to be exacerbated by the federal health law implemented in January 2014 (Vestal, 2013). Approximately 30 million Americans will be added to the rolls. This Qualitative study included interviews to gather data about the barriers and facilitators nurse practitioners experienced when they entered independent practice. Five participants were interviewed for this study. Four significant barriers were identified by all participants. These included financing the practice, requirement of physician collaboration, state restrictions, and third party reimbursement. Facilitators identified by all participants included use of accountants, reason behind entering private practice, educational preparation, location of practice, management services, and record keeping. Eighty percent identified the use of attorneys, family support, friends' support, and consultants as facilitators. Sixty percent identified colleagues as facilitators. With the increasing shortage of primary care physicians, independent nurse practitioners providing primary care are well equipped to fill this gap. This will aid the general health of the population as well as advance the nursing profession. |
