FORT WAYNE — For the first time, nurses in the area have access to a local option for attaining a doctorate degree in their field.
Indiana University-Purdue University Fort Wayne launched its doctor of nursing practice program this year through a cooperative partnership with Purdue University.
The program, open to nurses with a master of science in nursing, sets a milestone as IPFW’s first doctoral program.
But the significance of offering such a degree extends beyond a historical moment. The university now can produce health care providers with the ability to play key roles in filling the gap between a growing number of patients and the number of primary care physicians to treat them.
“You really have these highly trained professionals that are really capable of being part of the solution,” said Alex Krouse, an attorney who specializes in health care issues at legal firm Krieg DeVault’s office in Mishawaka. “You would hope more schools in the area would move in that direction.”
About 10 students are in IPFW’s inaugural doctor of nursing practice cohort, working to earn doctorate degrees to practice medicine. The three-year program primarily involves online courses through a collaboration with Purdue University’s campuses at West Lafayette and Calumet. Each school provides a concentration, or cognate, in a specialized field of study.
As IPFW concentrates on leadership in the new doctor of nursing practice program collaboration, Purdue’s West Lafayette campus will focus on quality improvement, and the Calumet campus will center on translation science.
The program includes developing leadership and business skills for interacting in the collaborative environment of modern health care, according to Lee-Ellen Kirkhorn, chair of IPFW’s nursing department.
“Leadership is not a solo act,” Kirkhorn said. “When you’re out in the field, you’re going to be the clinical leader. Having those ideas about how to put together a business plan is going to be really important.”
Understanding and applying business principles would play a big role in helping nurse practitioners who set up independent practices and in preparing those who decide to work in medically underserved locations.
“In Indiana, we have a crisis of major proportion because we don’t have the care getting out to those rural and underserved areas,” Kirkhorn said. “What we really need are primary care providers who can help people at the point of care, who can help people at the point of their need.”
For various reasons, the number of primary care physicians has not kept up with the growing population of patients requiring health care. The situation prompted the federal government to label counties, cities, portions of cities or population groups as medically underserved. Designated health professional shortage areas meet a combination of socioeconomic criteria where access to health care is limited.
A portion of neighborhoods on Fort Wayne’s southeast and south-central sides had shortage designations last year, as well as all but two of the counties in northeast Indiana, according to the federal Health Resources and Services Administration. Kosciusko and Wells counties did not have the label.
Indiana had about 3,650 nurse practitioners in 2014 and 4,411 primary care physicians in 2013, HRSA data show.
Nurse practitioners have an advantage in numbers, backgrounds and training to provide primary care services in underserved areas, but changes won’t happen overnight.
“I think a step forward is to be able to get people the care they need,” Kirkhorn said. “A lot depends on how a community is set up and how they can accommodate this new level of provider.”
The level of care provided by nurse practitioners is about on par with physicians. The health policy journal Health Review examined more than two dozen studies published since 2000 and found clinical outcomes from the two groups were similar.
“Doctors and nurse practitioners are all trained in health care, but they have different methods for solving the problem,” said Krouse.
In Indiana, nurse practitioners can practice independently without supervision by a physician. They can also prescribe medication, but only through collaborative agreements where they must have access to a physician who can keep an eye on prescribing practices.
“A nurse practitioner does not need a physician for anything other than some chart reviews that are related to prescribing,” Krouse said.
In providing health care, nurse practitioners, through their background and training, tend to excel in patient interactions, making them well-suited for treating chronic issues or listening to patients with many questions, Kirkhorn said.
“The ability to see the whole person in the context of their total environment — that’s the nurse,” said Kirkhorn. “It’s teaching. It’s helping people understand how to stay healthy, how to stay well, how to keep out of the hospital.”