Nurses and doctors working together can complement each other

EDITOR—Horrocks et al consider whether nurse practitioners working in primary care can provide equivalent care to doctors.1 It has reinforced much of my experience as a nurse running a general practice under the auspices of a personal medical services pilot.

My practice has been open for three and a half years and operates the philosophy that patients should be seen by the most appropriate person to help them. On average, 65% of patients choose to see the nurse and a small proportion of those require referral back to a general practitioner.

Concerns for patient satisfaction arose from my need to ensure the acceptability of a nurse led service to patients. By establishing a mechanism to listen to patients' concerns about their health and including patient representatives in the management of the practice, we have developed a service with a high standard of patient satisfaction.

Some may argue that patient satisfaction is a fickle concept that is impossible to measure and that such commercial concepts have no place in healthcare provision. Using the general practice assessment survey's patient satisfaction questionnaire, our patients showed that they felt valued and commented that they thought that nurses made better listeners and had more time than doctors. In reality, this perceived time factor issue is not the case in my practice, as the nurse often sees more patients than the doctor and the doctor tends to spend more time with the patients than the nurse. This is not surprising as he tends to see important medical problems for most of his surgery. Patients also expressed confidence in the nurses' clinical abilities and are surprised …