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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Three Goshen elementary schools — Chandler, Chamberlain and West Goshen — are providing free meals to all students during the school year as part of the U.S. Department of Agriculture’s Community Eligibility Provision of the Healthy Hunger-Free Kids Act of 2010. Nearly 80 percent of students at Chandler, 89 percent of students at Chamberlain and 78 percent of students at West Goshen already qualify for free or reduced-price lunches based on their family income. How do you feel about the new lunch program?

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