In the mid-1980s the Columbia University School of Nursing (CUSN) reconfigu
red its mission to once again become the premier training ground for clinic
al experts in nursing. its APN faculty members were expected to function as
APN primary care providers in some of its affiliated clinics.
Extensive studies at CUSN have validated the high quality and effectiveness
of comprehensive APN-managed patient care when compared to a randomly sele
cted group of patients manged by primary care MDs.
The issue of APN-MD primary practice fee equity for professional services a
t Columbia Presbyterian Medical Center was settled by agreement to the same
reimbursement per visit, while acknowledging that APNs would customarily h
ave longer contact time with each patient, and therefore a lower number of
visits per day.
The studies concluded that the ideal configuration of professional health c
are services would see APNs with hospital admitting priviledges alongside p
rimary care and specialty MDs working collectively to serve their patients
together in the new system.