Although, there is much scope for nurse practitioners in New Zealand, I would very much doubt if they provide even one twentieth the scope or function of any GP that I have met.
In addition, what makes you think NPs are any more likely to live in rural areas than GPs? (Read Carryer opinion piece “Train more NPs not GPs” here)
In reality, they are more likely to have restrictions caused by their family role, their children’s schooling and social life and, dare I say it, their spouse’s occupation. These are the same for all individuals and not really discipline-related but may more affect women than men (rightly or wrongly).
Individuals must also address the limited social life, social isolation, educational opportunities for children and access to a range of consumables that many such urban individuals take for granted. This is inevitably more problematic for all who train in the city and who may have come from urban environments (the majority).
Rural medicine is indeed very rewarding but a challenging primary care environment with greater demands that even urban GPs need to adapt to. The scope of rural medicine is definitely wider, has more limited primary and secondary support and the ‘on call’ far more daunting. One cannot cherry-pick.
Being a 9–5 NP in COPD, diabetes, elderly Care – those NPs one mostly have contact with – certainly don’t have a scope remotely comparable to a GP. As for NPs whose scope is primary care, these are still extremely rare and in my experience could never work in isolation – at least for many years – in the post. One day this may change but at present this is a reality.
If NPs are so motivated to work in primary care, why are they not more present in AFTER HOURS? It is here that there is a really great need for NPs dealing with the worried well and minor illnesses. This is not a denegration of their training as it is here where the (quite uncommon) risks occur. Knowing when things are not quite right requires real experience when much of the time very limited skills are needed and the risks of getting things wrong are minimal.
The waste of medical expertise here in a world of diminishing ageing doctors in New Zealand is a travesty. If NPs could show that they could tackle such a workload (15 minutes a patient) I might be impressed.
Despite these negatives, I do sincerely support the evolution of nurses to NPs by broadening their scope but cherry-picking narrow spectrum specialities cannot really be seen as being a GP.