Analysis of the work of nurse-practitioners in family practice and its effect on the physicians' activities.

A three-year study on the inclusion of nurse-practitioners (18 months basic training) in family medicine is presented. The nurses were entitled to screen patients and to treat minor ailments. Patient-nurse contact rates were 6.1, 7.1, and 4.2 per year in 1971, 1972, and 1973, respectively. The increased responsibility given the nurses resulted in a decrease in patient-physician contacts from 4.0 in 1970 to 2.0, 2.1, and 1.3 in 1971, 1972, and 1973, respectively. This permitted the physicians to spend more time with each patient, to look for disease in the community, to participate actively in the work of the department of medicine in the regional hospital, and to engage actively in research. As a result, numerous surveys have been performed and a great amount of important medical and epidemiological information has been accumulated. More than one third of all patients handled by nurses suffered from respiratory infections; these were followed by musculoskeletal disorders and skin infections. Diagnosis and treatment accounted for 50 to 53 percent of the nurses' activities. Consequently, the medical and social status of the nurses rose markedly and patients seems to rely increasingly on their judgment.