Goshen News, Goshen, IN

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December 8, 2012

WHOLE FAMILY: Advance-practice nurse an option to consider

It’s another “Wish I had a nickel for every time someone asked me that” question: They’ve had their babies. Now they’re looking for a doctor. Do I have a recommendation?

Over the years, I would offer a few names or suggestions, share what other parents had said or suggest — if the clients were English — that they look online for referrals or reviews. If their insurance companies had a suggestion or requirement, it was obvious: Go with that.

Recently, though, when asked that question, I’ve taken a different tack, and I’m a little sheepish I didn’t think of it sooner.

First, I answer the question with a question or two myself: What is it you need? What are you looking for? If the answers are simple — “Oh, just wellness checkups, maybe” — I’ve begun telling them about nurse practitioners.

Nurse practitioners? Some people aren’t sure. Also wish I had a nickel for: “I don’t know. I just thought you’re supposed to have a doctor.”

No, no universal law I’m aware of says every person has to employ a doctor. Or a plumber, lawyer, baker or candlestick maker, for that matter. There are mandates within certain payor policies, for sure, and many people and organizations recommend you “have” a doctor — I think they mean “retain,” “visit” or “seek the advice of?” — but unless you have an affiliation that requires it, you don’t have to “have” a doctor.

Not that it’s a bad idea. I “have” a family doctor — sorta. I’m on her books, at least, a spot I’m not quick to relinquish since she’s such a cool doctor she has a long waiting list. But the truth is I haven’t seen her in a few years. I don’t think she even knows I had another baby. (Oops.)

I have been enjoying the care of advance-practice nurses (APRNs). In fact, now that I think of it, that last visit to my doctor a few years back? I actually saw the family nurse practitioner (FNP) working there.

Advance-practice nurses — certified nurse-midwives (CNMs) — helped me have a baby, of course, which included the prenatal management of borderline gestational diabetes as well as a referral to a specialist for complicated blood labs.  They assessed and treated me post-partum, and they served as my baby’s care provider until he was 6 weeks old. He’s nearly 2 years old now, and I still consider them my first call if I have any questions about his health — though, admittedly, I enjoy a bit of familiarity.

Should I tell you, then? My children, save the foster daughter born early to a sick mother, have not seen a pediatrician? Don’t worry. They’re fine. I’d take them to see a doctor the minute they needed to; it’s just they haven’t needed to.

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