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Health care reform of some sort is likely to become law and add millions - probably tens of millions - of patients in the nation when there is already a shortage of general practitioners among doctors.

Some of that extra care will be provided by a health care professional familiar to few people: the nurse practitioner.

According to MedLine Plus, the information service of the National Library of Medicine and the National Institutes of Health, nurse practitioners have graduate degrees in advanced nursing practices and can provide a broad range of services, such as:

n Diagnosing, treating and managing diseases

n Providing prescriptions and coordinating referrals

n Performing exams, taking medical histories and ordering lab tests

n Promoting healthy activities for patients

n Performing procedures such as bone marrow biopsies or lumbar punctures

Julie Lambert is a nurse practitioner who has an independent practice in Stafford Township, which is still a rarity in the profession, she said.

Most nurse practitioners work with doctors in primary care offices, others with specialists or in emergency rooms, she said.

Each state sets its own requirements for nurse practitioners. In New Jersey, they must have an agreement with a licensed physician to be available electronically at all times to provide advice or consultation if needed, she said.

And when nurse practitioners write prescriptions, which can cover the same range of medicines as a physician, they must do so on a prescription pad that includes the name of the affiliated physician, she said.

"We're considered the invisible providers of health care, but we're out there every day, seeing patients," Lambert said. "We don't get a lot of credit, but we enjoy what we do."

The American Academy of Nurse Practitioners would like to raise the profession's profile. Playing on the anticipated shortfall of providers due to health care reform, it has mounted a campaign it calls "125,000 solutions to the health care problem," referencing the number of nurse practitioners nationwide.

People making career plans in this high-unemployment recession might want to consider joining them.

Health care has been the strongest job sector this decade, with employment in Atlantic County jumping from 13,000 in 2001 to 16,000 by 2008. And with the baby boomers retiring, the need for health care services is expected to keep growing substantially.

Lambert said demand for nurse practitioners is cyclical, as it is for other kinds of nurses.

"But in this area there aren't enough nurse practitioners for the demand. I hear of openings every day," she said. "There are physicians who want to hire NPs who go for years and can't find anybody."

Lambert said nurse practitioners also can help control the cost of health care.

"We can provide primary care at a little bit lower cost than a physician, especially if you're talking about Medicare and Medicaid," she said. "We're reimbursed only up to 85 percent of what physicians receive for those."

With their focus on preventive medicine and the ability to spend a little more time with each patient, nurse practitioners do very enjoyable work, she said.

"I have the best job in the world. I like to help people and see them live long, healthy lives and enjoy things," Lambert said.

And more people will be seeing nurse practitioners as their first medical contact, based on current trends in health care.

Contact Kevin Post:

609-272-7250

KPost@pressofac.com

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