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FOX 40 Anchor Sonseeahray Tonsall: “A new report from Comp Health indicates 11 million Californians live in an area with a shortage of primary care providers. Research done by staff.com shows that last year the national average wait to see a new physician was 26 days. Appointments at smaller clinics may be the answer instead of going the hospital route. but some warn you may only get to see a nurse practitioner if you do that. Only. Is that a fair sentiment and are you settling if you book an NP? Here to help us understand just what a nurse practitioner is and if going to one means getting lesser quality of care at all is Surani Hayre-Kwan, a nurse practitioner at the Russian River Health Clinic in Sonoma County. She is also a Nurse Administrator for Sutter Health. Welcome to FOX 40 News at 11.

Surani Hayre-Kwan: “Thank you. Happy to be here.”

Tonsall: “Surani, first, if you could describe what a nurse practitioner is and does and how that’s different from being a doctor.”

Hayre-Kwan: “Well, I like to tell my patients when I see them that really the way I’m trained is different than a physician. I’ve been a nurse for 31 years, so my background is nursing and then I went back for my graduate degree to become a nurse practitioner. I learn all of the information that I need to learn, similar to a physician: how to diagnose and treat diseases, prescribing and ordering tests and reviewing them, and making decisions based off of the results of those for patient care. I work with consultants, I send patients to specialists and really I can provide a level of care for the patient so that I can be their primary care provider for many, many years.”

Tonsall: “As people talk more and more about what is a crisis in this country, the growing shortage of doctors, what about this suggestion that you can get an appointment faster, but it may only be with a nurse practitioner.”

Hayre-Kwan: “Yeah, that really is very disappointing for me as well. I provide very high-level care for my patients as do my colleagues, both nurse practitioners and physician assistants. It really is important to our physician colleagues to have nurse practitioners and even physician assistants in the office because we provide very high-level quality care, and our patients are part of the greater care we provide in the clinic. So, it’s not just a physician, a nurse practitioner, but it’s also our medical assistants, our schedulers, our nurses, and our LVNs [licensed vocational nurses] that are all really part of the team providing the care to the patients. No patient should ever feel like they get less than quality care when they see a nurse practitioner.”

Tonsall: “AB 890, which went into effect earlier this year in California allows nurse practitioners who do 3 years of clinical work to work without physician supervision in certain facilities. After those 3 years, NPs could have full practice authority. Describe if you would, the nature of the physician supervision that has been required. Are they just signing off on what you’ve done or is there a lot of critique of what’s being done and is that in the middle of an appointment or after?”

Hayre-Kwan: “Well, that’s a really complex question. And I don’t know that we actually have time to cover all of it. But I will say that the change in licensure for nurse practitioners in California – going to a 103 – doesn’t change what you actually do with a nurse practitioner. For example, I’ve been a nurse practitioner for 21 years and I am now officially licensed as a 103 Nurse Practitioner. But I continue to deliver exactly the same type of care that I’ve delivered to my patients for the 21 years that I’ve been a nurse practitioner. I think that’s the biggest learning that many of our health care colleagues have because they may think that it’s a change in what I’m allowed to do, but it is not. It doesn’t change the fact that I continue to function as a nurse practitioner doing the things that I’ve learned to do. Even learning new skills as needed for our clinic. Now, I will say that, prior to that, you know, working as a nurse practitioner with a standardized procedure — that’s what that’s called, it’s an administrative document – and it’s currently required in the state of California for new nurse practitioners and for the initial 3 years of your practice before you can apply to be a 103. Now, the standardized procedure really takes all of the language that’s currently in law and puts it into a document that the nurse practitioner and the physician supervisor will review and look at, hopefully every year, and decide if there are any changes they want to make to what the nurse practitioner is actually doing in the office. So really, I tell people an administrative document is really what that is. It doesn’t really reflect what the nurse practitioner is doing on a day-to-day basis. The law, you can just point to the lines and say this is what an NP is allowed to do and standardizes procedures are more restrictive than the actual law is.

Tonsall: “Thank you so much for joining us this morning to sort of explain what can be a key bridge in this very critical time in the medical profession.”