Handmaidens or agents for managed care?

General practice pp 1038, 1043, 1048, 1053

Set against what we already know about nurses working alongside general practitioners, 1 the four trials of nursing in primary care in this week's BMJ give us a better idea of what the future of primary care might look like.2^–5 Most people seeking a rapid response to their symptoms or concerns accept practice nurses or nurse practitioners in front line roles, although a substantial minority continue to prefer a doctor's opinion after experiencing nursing attention.2

On average, nurses have longer consultations, arrange more investigations and follow up, provide more information, and give more satisfaction than general practitioners. Primary care nurses are not cheaper than general practitioners, 3 but they are as safe in managing self limiting illnesses.

Nurses undertaking triage assessments by telephone with computer decision support may reduce the number of visits to general practitioners, hospital use, and costs.5 The trials do not tell us anything about the medicalisation of …