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The INDEPENDENT, April 19, 2007
To Your Health!
By Judy Hargis, P.A., and Audeen Wagner
Who is my Primary Care Provider?
ventive health and treating the “whole” person.
Mid-level practitioners: This includes Nurse practitioners (NP), physician assis-
tants (PA-C), and certified Nurse Midwives ( CNM );
• Nurse practitioners are registered nurses who are prepared through advanced
education and clinical training to provide a wide range of preventive and acute
healthcare services to individuals of all ages. NPs can take health histories, provide
physical examinations, diagnose and treat many common and chronic medical
problems, interpret laboratory results and x-rays, perform minor procedures and
prescribe medications. Their training places a strong emphasis on preventive care.
They can practice independently or in collaboration with a physician. Almost all NPs
are trained at a master’s level.
• Physician Assistants are healthcare providers licensed to practice medicine
with physician supervision. Comprehensive responsibilities include physical exams,
diagnosis and treatment of acute and chronic medical problems, interpreting lab re-
sults and x-rays, casting, suturing and assisting in surgery. A typical PA applicant
has a bachelors degree and four years experience in a health profession such as
nursing, Paramedic, respiratory therapy, physical therapy, medical corpmen, and
sometimes pharmacist/pharm-D etc. PAs must pass a national certification exam to
obtain a state license and sit for a re-certification exam every 6 years, while logging
100 hours of CME (continuing medical education) every two years. Studies have
shown that PAs and NPs have demonstrated their clinical effectiveness both in
terms of quality of care and acceptance.
• Certified Nurse Midwife (CNM) provide comprehensive prenatal care, delivery
and postpartum care. They work in a collaborative role with OB/GYN physicians
and consult with or refer to other healthcare providers. Numerous studies over the
last 20 to 30 years have documented the ability of CNMs to independently manage
about 80 percent of all prenatal care, labor, delivery and postpartum care and 90
percent of gynecologic care for women of all ages.
All members of the healthcare team are valuable. They often work in clinics to-
gether and in collaboration professionally. In light of the primary care shortage we
are facing, this group of healthcare providers will continue to make a significant dif-
ference in accessability to quality healthcare. For further information on these pro-
fessions you can access the following web sites: www.ama- assn.org, www.osteo-
pathic.org, www.acnpweb.org, www.aapa.org, www.acnm.org.
Healthcare in this country has changed dra-
matically over the last few decades. There are
many challenges for patients trying to navigate
the system. Gone are the days of the General
Practitioner who took care of several genera-
tions within a family, often owned his/her own
practice and remained in the community for
many years. A visit to the “doctor” today can be
confusing and overwhelming. Changes in clinical
practice have affected the continuity that we
once relied on. Many factors have been responsible for these changes. They in-
clude higher healthcare costs, lower reimbursement for services provided, more
administrative and productivity demands on providers. Our society is more mobile
and there is more Provider turnover within clinics. Statistics show that fewer med-
ical school graduates are choosing to go into primary care, opting for specialty
medicine.
Many clinics have multiple partners and it can be frustrating for individuals seek-
ing continuity with their chosen provider. Health insurance plans can “muddy the
water” even more. Employers often change health plans and that change can mean
being assigned to a new contracted clinic or provider.
We all need to educate ourselves and learn how to navigate the healthcare sys-
tem. It is important that we are armed with knowledge that will help us to be con-
sumers of the most cost effective, quality healthcare possible. This column will take
a look at healthcare providers and their roles in providing primary care to you. The
next several columns will provide information on understanding health insurance
options, ways to reduce our health costs and an introduction to integrative holistic
medicine.
Let’s review who our providers are:
Physicians: We all know what a medical doctor is, but do you know what an os-
teopathic physician (DO) is? In many ways MDs and DOs are alike. Their under-
graduate and medical school training are similar. They both participate in intern-
ships and residency programs after completing medical school.
Both choose to practice in specialty areas like pediatrics, orthope-
dics, surgery, OB/GYN, etc. They pass comparable examinations
to obtain state licenses. The one difference is that DOs receive
Mosquito season is ap-
additional training in your body’s interconnected system of proaching and public health of-
nerves, muscles and bones. There is a strong emphasis on pre- ficials are reminding the public
that mosquitoes can transmit a
number of diseases, including
West Nile Virus (WNV). In
2006, the first year for WNV in
Oregon, Clackamas County
had no cases, Multnomah
West Nile Virus reached Oregon in 2006
County had five positive birds,
and Washington County had
one positive bird. Clark County
Washington had one human
case.
The spread of West Nile
virus is unpredictable; however,
trends throughout the country
have shown a significant in-
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crease of cases in the second
year of the virus. The following
is an overview of West Nile
Virus along with some preven-
tion tips.
What is WNV?
West Nile Virus is carried by
infected mosquitoes. It can
cause serious illness in some
people and horses. Mosquitoes
become infected when they
feed on infected birds of the
Corvid family, such as ravens,
crows, jays and magpies. The
Please see page 22