When Margaret Manchester was training to be a nurse, she was taught to stand up whenever a doctor entered the room and to offer him her chair.But nurses are no longer handmaidens to the medical profession...Pat Moccia, chief executive of National League for Nursing, said: "What I think we're going to see in the future is that the family doctor is going to be a nurse practitioner. That's where we're headed, as doctors get more specialized, and advanced-practice nurses take over more routine care...But what the nursing groups see as the natural evolution of health care the American Medical Association sees as a growing danger...A 1986 report by the Office of Technology Assessment, an investigative arm of Congress, estimated that 60 to 80 percent of the basic health care performed by doctors could be done by nurses with the same results, at a lower cost.And earlier this year the American Nurse Association released a study comparing care by doctors and nurse practitioners, finding that nurse-practitioners offered better-quality care, as assessed by the accuracy of diagnoses and the completion of comprehensive medical histories, and at a lower cost.Not surprisingly, the A.M.A. challenged those findings.
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