Nurse practitioners (NPs) confront a professional paradox. Patient satisfaction with NPs as primary care providers is equivalent to or higher than satisfaction with physicians, and outcomes are comparable if not higher,1-3 yet we are often invisible in the public eye.4-6 In any event, while we are represented nationally by tireless advocates and professional organizations, we can each play a part in speaking up for our profession.

NP Prescribers

I recently opened an e-mail for an online survey to assess response to various advertisements for prescription medications. Unfortunately, the only categories available were "physician" for those who prescribe, and "nonphysician" for other healthcare professionals who do not prescribe. I signed on as a "physician," completed the survey and then sent a letter, some of which is quoted here:

"I hope that by corresponding with you, I can help your company understand that APRN Nurse Practitioners are MAJOR prescribers of many of the medications in your survey, and that it is frankly insulting to our profession not to be recognized as such. It is also short-sighted because it does not assess response to advertisements from a significant body of prescribers.

I filled out the survey as a "physician" since I am a prescribing provider and because I wanted to see if there was anything in the survey that would preclude NPs from participation. I found that I prescribe at least 50% of the medications you profiled. I appreciate this opportunity to convey my concerns."

I almost did not tackle this - it took reflection and time away from other projects and deadlines, but I decided this was important. Recently, I was at an NP conference where a representative had a training video for a device that I and my APRN colleagues commonly prescribe and insert, labeled "Physician Training Video." After I commented on this, the representative responded, "Yes, we heard that from NPs and have changed it to 'Provider Training Video.' This is just the old tape because I'm out of new ones."

I used to do HIV counseling and testing under a poster that said "AIDS... you can't tell if someone has it by how they look. Only a doctor can tell if someone is infected." I fixed it with a black marker until I replaced it.

It has become clear to me that not responding can have a cumulative negative effect on our profession, and I urge my colleagues not to pass up opportunities to speak up for who we are and what we do.

Oh, and I just received a response from the Senior Projects Director of the online survey stating that she, "appreciates the insight and feedback," and that she will take it up with the Association of Medical Publications who sponsored the survey. She further noted, "They should be made aware of the ramifications of limiting their response to only physicians. It seems a disservice to not include the opinions of everyone who prescribes."

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