The changing healthcare landscape

. . . . While doctor nurses are still a rare breed nationally, that's about to change dramatically. The first class of 24 doctor nurses graduated in December from the University of Minnesota's School of Nursing, one of a handful of schools at the forefront of this trend. All have returned to their jobs or new positions, some with expanded roles and pay. Now more than 90 nursing schools have introduced DNP programs and 200 more are about to start. Beginning next year, the University of Minnesota is converting its entire master's of nursing practice program into a doctoral course, meaning any nurse practitioner who passes board exams will be a doctor nurse. . . . . Experts are forecasting a shortage of physicians in the country by 2020 because the population has grown even as enrollments in medical schools have remained flat. What's more, 36 percent of active physicians are older than 55 and most will retire by 2020 . . . . The shortage is already showing up in primary care, which includes family medicine, pediatrics and internal medicine. This year, U.S. medical graduates filled just 1,156 of 2,387 residency positions nationally in family medicine; the rest were filled by foreign medical graduates. Primary care doctors are paid far less than specialists. . . . According to Delaney, there is already an 80 percent overlap between what nurse practitioners do and what primary care physicians do.