US demand continues for nurse practitioners and support staff

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Nurse Practitioners (NP's) are Registered Nurses (RN's) with specialized training and advanced degrees. A trend has been developing in the health care field for these persons to take on more and more work of doctors as doctors themselves become scarce in relation to demand. Strong opportunities for work permits and immigrant & non-immigrant visas are being created.

Nurse Practitioners first appeared in the field of paediatrics about 40 years ago. They rapidly began to enter into other fields such as obstetrics and gynaecology, family medicine, and adult primary care. Physical Therapy is the first place for recovering stroke or heart attack patients, as well as accident victims.

NP's are qualified to perform many of the duties of primary care doctors, such as performing physical exams, diagnosing and treating common health problems, prescribing medications, ordering and interpreting X-rays, and providing family planning services.

Healthcare practitioners in Physical Therapists (PT's) require higher levels of professional education and certification, similar to RN's. However, once a patient reaches a level of recovery that does not requires such intensive monitoring, they are usually moved to Restorative Therapy, which is overseen by a PT, but uses aides that are trained at lower levels in therapy techniques.

It is very similar to nursing care's more mundane tasks that do not require a 4-year degree to do: such as a bath, or basic treatments. Restorative aides are trained to help with ambulation, exercises and they have to document the patient status.

Physical Therapists generally make much more money, largely because their training is at such a higher level. Also, there is a shortage of PT's, meaning that patients are moved to Restorative Therapy sooner, when it is possible, which is driving the demand for workers in this area.

Private clinics exist, and more are being created, that have very few or no doctors to cover these shortfalls. Existing businesses are competing for health care workers, and new businesses are springing up. Currently, more than 170,000 RN's and similarly qualified individuals are needed in the U.S, with a shortfall of about one million expected by 2020.

The number of nurse-managed primary care centres has increased from a small handful fifteen years ago to about 250 across the U.S. today.

And, the support staff required for them is also suffering a serious shortage.

Enhancing this trend is the fact that fewer doctors are choosing primary care as their speciality, and projections are that this will not turn around soon. This will drive more nurses to register as NP's, which will continue to drain off the labour force at the RN level and the support staff level, as these people continue training and education to reach higher levels of certification.

According to the American College of Physicians, medical school surveys show that, from 1998 to 2005, the number of third-year resident doctors (post-graduate training) intending to pursue careers in general internal medicine has dropped from 54 to 20 percent. Many new doctors are choosing much more lucrative specialty careers to pay off high student loans required to obtain advanced medical degrees in the U.S.

The number of general-practice physicians is falling at the same moment that the baby boomer population is reaching a more advanced age and is in greater need of medical care. NP-run medical centres are critical toward covering the shortfall, which is seen as being in its initial phases now.

Nurse Practitioners also have steadily been gaining greater acceptance by insurers in most of the country. In about half of the states, NP's - who frequently charge lower fees for office visits than doctors - are now recognized by insurance carriers as primary care physicians. Often they can practice either independently or with remote direction from doctors.

Remember that gaining a work permit to work for another company is only one possibility. Qualified persons who can start their own business or buy into a partnership can issue a work permit to themselves from their own business to obtain a visa or green card.


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