NPs: vital signs of a healthy community

SANDPOINT — Holistic healing, a commitment to quality care and prevention instead of medication — for many, these are the key ingredients of ideal medical care. For area nurse practitioners Cynthia Dalsing and Nichole Grimm, these are the essentials they provide to patients on a daily basis.

“NPs are expert clinicians with advanced training who provide primary, acute and specialty health care,” according to the American Association of Nurse Practitioners.

In Idaho and 20 other states, NPs have full practice authority. They diagnose and treat medical conditions, prescribe medicine and manage overall patient care. They also refer patients to specialists as necessary, according to AANP.

Dalsing opened her private practice, Women's Health Care, 16 years ago. She and NP Tabitha Barron maintain a successful practice that continues to grow as more community members seek care. Grimm heads a private practice associated with Woodlands Family Medicine.

“We have some barriers in Sandpoint in access to healthcare,” said Dalsing during a brief break in her packed appointment schedule. “I have been practicing now in Sandpoint for 20 years, but there are only so many people providing care.”

Medicare and Medicaid are two of these barriers, Dalsing said.

Both of these government-sponsored programs reimburse healthcare professionals at lower rates than conventional insurers, she said. Many physicians will not accept new patients on such government programs, leaving senior citizens and low-income residents without access to medical care.

Additionally, NPs frequently collect even less than physicians from Medicare and Medicaid for the same services.

“NPs do not require a relationship with a physician to open an office. But Medicare and Medicaid reimburse me 15 percent less because I don't have a physician in my office," she said. “There's a financial disincentive because of a random law.”

“I don't turn anyone away for Medicare only. But nobody wants to work for nothing. I feel like we are practicing invisibly. NPs treat about 50 percent of people in town,” Dalsing said. “It's important for (the sake of) statistics and for people running healthcare for the nation to know who's providing the care.”

Dalsing culled national recognition in 2015 as the recipient of a prestigious Inspiration in Women's Health Award. Conferred by Nurse Practitioners in Women's Health, the honor reflects Dalsing's commitment to providing passionate, high quality care. According to a press release, her patients have complete trust and confidence in her.

“There certainly are practices when you are just on a conveyor belt. But we really are committed to quality care,” Dalsing said.

Grimm pointed out that NPs, with their emphasis on preventative and holistic care, help keep people out of the emergency room.

“We are passionate about prevention,” she said.

“The reality is that nurse practitioners are filling an important primary care role in a cost-effective way. Even though Medicare and Medicaid reimbursements are low, that doesn't change the quality of care we give.”

Both Dalsing and Grimm agreed that the Sandpoint area needs more NPs to treat underserved residents.

“As a group, we're trying to pull more NPs into town because it's a no-brainer,” Dalsing said, citing gerontology and psychiatry as two of the disciplines in Sandpoint that are desperately in need of nurse practitioners.

“With the growing medical needs of our society, nurse practitioners are key,” she added.