Nurse Practitioners Play Important Role in Primary Care

Jun 14, 2016 at 10:31 am by steve

Brandi Carbonie

Brandi Carbonie remembers the day she decided on a career in medicine. "I was about eight years old, sitting on the couch with my mom watching the first episode of St. Elsewhere [the television medical drama], and I told her I wanted to be a nurse,” Carbonie says.

She followed her dream, and today works as a nurse practitioner (NP), an increasingly important role, especially in the field of primary medicine.

A recent government survey shows that some 58 million Americans live in locations that are designated as Health Professional Shortage Areas, defined as a population whose supply of primary care professionals falls below federal standards. And demand is expected to rise in coming years due to population growth and aging.

There is a high demand for primary care in the Birmingham area, and Brookwood Baptist Health is adding more nurse practitioners to their primary care centers.

Carbonie practices at the Brookwood Baptist Cahaba Heights Primary Care, along with Douglas Lipperd, MD. Lipperd says NPs play an important role as a physician extender.

“Brandi and I share a similar philosophy and practice style,” Lipperd says.  “With the two of us, we're able to see more patients in a timely manner. That way, one of our patients doesn't have to go to an urgent care facility to see somebody quickly. So it's nicer for them to stay within the practice even if I can't see them personally."

Carbonie worked as a Registered Nurse for 15 years before returning to school to gain her NP credentials. She's glad to see today's more holistic approach to care in comparison with a generation ago.

"We're big on preventive care," she says, "and one of the things I'll do, especially with new patients, is to be sure everything is up to date. And we try to avoid using drugs whenever possible. For example, we use physical therapy for chronic pain. And someone with a backache, for example, might use stretching, massage, and heat therapy.

"Until recently, NPs didn't have the independence we have now. The fact that we're able to get our DEA license is huge. We were excited because we were one of the last states to do that. So it helps us to practice more independently."

James Colvard, MD, of Brookwood Baptist Oak Mountain Primary Care, agrees that the nurse practitioner plays an important role in healthcare. "In a typical day, an NP might do a range of things from seeing patients with hypertension or diabetes to high blood pressure. Not only does she allow me to see more patients, this also gives me more time with each patient when I have a busier day,” he says.

"Sometimes she'll start the process, seeing a patient before I do, and I come and follow after. So I can see a few more patients in a day because of that."

A typical day for might include patients with diabetes, hypertension, asthma, sinus issues, sprains, or stomach problems. During the time she's not seeing patients, she might be doing anything from reading lab work, analyzing test results, to following up with a specialist they’ve referred to.

One of the appealing things about primary care, Carbonie says, is the wide variety of patients it provides. "I see pediatric patients as well, so the patient I'm seeing might be two years old to a hundred years old. It's especially good when you get to know your patients and watch them improve."

"The longer that NPs are around," Lipperd says, "the more they've come to be accepted both by patients and by insurers. Patients are more comfortable seeing them, and physicians are more comfortable working alongside them. So those have both been very positive changes."





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