CNPs help fill physician gap
By MEGAN FEDDERSEN — Sentinel Staff WriterArticle Photos
FAIRMONT - With the alphabet soup of medical acronyms, knowing who's who and what's what is confusing for the average patient.
"Have you thought about going on to get your LPN?" one person asked Shelley Brennan-Vuocolo, a certified family nurse practitioner at Fairmont Medical Center.
With bachelor's and master's degrees in nursing and 28 years' experience in the field, the question had to make Brennan-Vuocolo cringe a bit.
She calls mid-level providers - like herself and physician assistants - extensions of physicians, an appropriate description since the positions were developed to cover a shortage of primary care physicians.
"I will say over and over I'm not a doctor," she said.
Becoming an LPN - licensed practical nurse - was the first step in her career, before she became a registered nurse. Her current title required another degree from Binghamton University, New York, where she was also certified in family health and maternal-child health. Brennan-Vuocolo also has studied in the fields in pediatrics, obstetrics and gynecology, surgery and family medicine.
Her work background is varied too. In Boston, she was part of a multi-specialty practice with 1,000 providers, which exposed her to a wealth of knowledge, she said. Then in New York, she and her husband had their own urgent care practice, and she saw primary care patients during that time as well. Her husband, Dr. Philip Vuocolo, is a general surgeon also employed by Fairmont Medical Center.
The diverse experience "helped me to learn autonomy and helped me learn where my limitations are and to be comfortable with that," she said.
As a nurse practitioner, she can diagnose, treat, order tests and make referrals.
"Initially nurse practitioners were placed to do preventative health care - obviously that's not all we do," she said.
Brennan-Vuocolo has been in Fairmont since July, and patients are responding well to her, according to Darla Nelson-Philipp with the medical center. Brennan-Vuocolo said growing up in a small town and working on her family's dairy farm in upstate New York helps her relate to the rural community in southern Minnesota.
"I almost feel like I'm home here," she said.
Just the fact that she's female is appealing to many women who prefer seeing a female practitioner for health issues. As medical facilities struggle to recruit physicians, especially women, mid-level providers are helping to fill the gap.
In 2006, there were half as many female physicians in general practice as their male counterparts, according to a study, Physician Characteristics and Distribution in the U.S., 2008. The number of women graduating from medical school is now equal or surpassing men, but few from either gender are choosing family practice and instead opting to specialize, so the role of mid-level providers could very well continue to increase in patients' lives.
"Women's health includes a lot of preventative care - and mid-level providers fit perfectly," Brennan-Vuocolo said.
She knows of women who have skipped important screenings and avoided discussing uncomfortable problems because their primary physicians were men.
"I hear that from women all the time," she said. ".... I don't think they realize - when they say they don't feel comfortable asking about something - even though he's a man, he's specialized in it."
Avoiding those topics can mean a difference in life and death - a lesson Brennan-Vuocolo learned from her own mother who died of endometrial cancer.
"Any type of concern or question is really not something they've not had to deal with before," she said.
