The next time you visit your doctor’s office, it’s possible you could be seen by a nurse practitioner, not a physician. For routine care such as checkups and treatment of colds or even chronic conditions, nurse practitioners are being seen more and more in many places.

According to the American Academy of Nurse Practitioners, a nurse practitioner ?has advanced education and clinical training in a health-care specialty area.?

Ernestine Kotthoff-Burrell, a 28-year veteran of the field and a faculty member in the School of Nursing at the University of Colorado Health Sciences Center in Denver, said a nurse practitioner (NP) is one of several in the nursing field considered to be ?advanced practice nursing,? requiring both bachelor’s and master’s degrees in nursing.

More than 200 programs across the United States provide some training for nurse practitioners, with specialties ranging from public and family health to obstetrics and gynecology. NPs can deliver much of the routine health care many patients require, turning their most acute and complex cases over to physicians and specialists for further care.

While NPs cannot perform surgery themselves, for example, they can assist during an operation. With additional training, NPs are able to write prescriptions as well.

A key element that sets NPs apart from physicians and physician assistants is how they deliver their care. ?NPs are run by the nursing model (and) developed under the nursing model, which is more caring-oriented, more toward the whole person,? said Catherine Fries, an NP at the Boulder Women’s Clinic.

Where physicians often see patients only when they’re quite ill, NPs can focus on a wellness approach to health care, keeping people healthy by encouraging lifestyles and choices that help them avoid illness in the first place.

?Research has shown that nurse practitioners can provide very high-quality health care, and, in many instances, their care can ultimately result in a savings ? if we can keep people out of the hospital or nursing homes,? said Kotthoff-Burrell. ?Ultimately, we can save money and provide high-quality care.?

Some might see increasing use of NPs as a way for HMOs and others to cut costs and trim patient’s time with doctors. But neither Kotthoff-Burrell nor Fries agrees with that train of thought.

?You’re not substituting sub-standard care for physician care,? said Kotthoff-Burrell. ?It’s been shown (in research) to be very high-quality health care and cost-effective. We together provide a much broader spectrum and higher-quality, more comprehensive care.?

Still, some patients don’t see it that way, and it is frustrating for Fries. ?I think patients aren’t always educated on what we can provide. At my last practice, they really felt like, ?I couldn’t see the doctor so I had to see you.’ ? Yet Fries feels that, for her, the good of her work far outweighs the bad.

?I love what I do, I love my patients. I love being able to spend time with them,? said Fries. She also likes that she’s never on-call, unlike other physicians, and gets to spend weekends with her family.

Kotthoff-Burrell echoes Fries’ enthusiasm for the work of an NP. ?I don’t ever regret becoming a nurse practitioner. It’s tremendously rewarding,? said Kotthoff-Burrell. Adding that ?the role of (NPs) has gained respect over the years ? the role has been on the forefront in developing new frontiers in health-care delivery.?

And as the profession continues to gain in stature, places like the CU’s Health Science Center will play an important role in advancing the training of nurse practitioners.

In fact, CU’s School of Nursing is considered the birthplace of the movement toward nurse practitioners. And in 2001, it won acclaim from U.S. News & World Report, which ranked both its programs for Pediatric Nurse Practitioner and Family Nurse Practitioner as third-best in the nation, while the Adult Practitioner was ranked eighth.

One issue facing NPs, as well as nursing in general, is a shortage of qualified professionals. Many have called for higher starting salaries to attract more to the field, and both Fries and Kotthoff-Burrell believe salaries for NPs should be higher. Kotthoff-Burrell estimates starting salaries for NPs in Colorado is around $60,000, and can go higher then $100,000 after several years of experience.

?I think we do deserve to make more money,? said Fries, ?we have the same liability risk as, say, an internal medicine doctor or someone that’s not delivering babies.?

Competition to gain admission to NP program at CU is ?very competitive,? said Kotthoff-Burrell. ?It should be. We have ominous responsibilities on the other side of graduation.? The schools’ graduates enjoy a very high rate of employment when they finish, Kotthoff-Burrell adds. She said there are about 3,800 NPs practicing in Colorado and just less then 100,000 nationwide.