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FOCUS Cardiometabolic Risk
Certified as both a Family and Adult Nurse Practitioner, Wendy Wright is employed in a private family practice in Merrimack, NH.
Certified as both a Family and Adult Nurse Practitioner, Wendy Wright is employed in a private family practice in Merrimack, NH. She is a general partner in Partners in Healthcare Education, LLC, and serves as the Senior Lecturer with Fitzgerald Health Education Associates, Inc, a national provider of NP board certification preparation. A past president of NPACE, Ms. Wright was chosen by the American Academy of Nurse Practitioners (AANP) in 1999 as the recipient of the New Hampshire State Award for Clinical Excellence, and was inducted as a Fellow in the AANP in 2005. She is also the recipient of the Excellence in Research and Excellence in Clinical Practice awards from Simmons College. Ms. Wright is a faculty member of Medscape’s Ask the Expert Nurse Practitioner website and an editorial board member of Medscape’s E-journal.We spoke with Ms. Wright about APCToday.com, a new website designed “to deliver the most up-to-date clinical information from primary care and a range of medical specialties to an audience of advanced practice clinicians.”
Has it been your experience that nurse practitioners, physician
assistants, and other advanced practice clinicians are most interested
in physician-centric material and want access to the same
information they would find in the other clinical journals?
That is absolutely true, because as advanced practice clinicians,
we’re being asked to make the same diagnoses as physicians;
we’re being asked to prescribe; we’re being asked to provide the
same educational materials to our patients that physicians are;
and we’re being held to the same standard of care—so when I am
talking to our customers, one of the things I always say is ‘do not
dumb down any information, we want the same information that
you give to your physicians.’ We may use it differently in the way
we interact with our patients, but we want and we need that same
information provided to physicians.
What special features can visitors access at APCToday.com?
What we are trying to do every month is to provide something
new and exciting on the site. We are going to offer podcasts
and webcasts; we have a series of three that are currently
scheduled. We are constantly populating the site with new CE
opportunities, monographs, and articles. One of the other nice
features of the site is that we have links to every state organization
that represents nurse practitioners, as well as physician
assistants, clinical nurse specialists, and midwives. We did that
because we want to provide a benefit to these state organizations
by allowing people who go to our site to link back to some
of their professional societies and organizations. We feel that
there is no other site out there that provides that type of opportunity
all in one place for clinicians. Every state has an organization
that represents nurse practitioners and a separate one
that represents physician assistants. Until APCToday.com, there
wasn’t a centralized resource for nurse practitioners, physician
assistants, and other advance practice clinicians that provides
information about the state and national organizations and lets
people know about upcoming conferences, how to become a
member of your state organization, and other information. We
really want to provide a valuable service to these state organizations—
we want to direct people back to them and get their
membership up. In turn, we are working on linking with the state
organization so that they reciprocate and tell their members to
visit APCToday.com.
Has that been a productive partnership so far?
It has. You know, the hard part for us is that basically these organizations
are all run individually. In fact, most of them are run by volunteers,
which doesn’t make it easy because they rotate through
every year. From our point of view, it is a lot of work, but it is very
rewarding once we can get these state and national organizations
to partner up with us. Now that we’ve done that, we’re getting a
lot of momentum on APCToday.com, and we’re finding that visitors
tend to come back repeatedly and spend more and more time on
the site.
Tell us about the resources visitors
will find in the “Clinical Inquiries” and
“Practical Strategies” areas of the site.
We are going to continue to populate the
site with queries and clinical questions
sent in by people, and we are going to
have some of our experts respond to
those questions. What we are hoping
to do is provide useful clinical information,
because often, the longer you’ve
been in practice, the more difficult it is
to find what you are really looking for
in textbooks, because the textbooks
provide basic and general information.
Once you’re in practice, you come across
these unusual presentations, and I think
APCToday.com will provide people with
very useful clinical information and guidance
about clinical
situations and questions
they have
wondered about:
What are you doing
in regard to this
disease? How are
you managing it?
What are the newest
options on the market?
Do you think at some point you might
turn that into an interactive forum or
community where APCToday members
can interact directly with one another
and discuss clinical problems and
approaches?
That is certainly something that we have
discussed eventually doing. One of the
worries that we have regarding that
approach is that it would require someone
to monitor or moderate the discussions,
because we don’t want to put information
out there that is not evidence-based or
otherwise validated, for fear of providing
people information that may not be
accurate. We all have a million anecdotal
stories about these different options and
approaches to treatment that worked out,
but in today’s environment, in which we
are really being held to evidence-based
standards, it makes me a tad worried
about creating an interactive community
without some close scrutiny about what is
being said out there.
Will APCToday have resources that
focus on intra-abdominal adiposity and
the ECS?
Yes, there are going to be three discussions
by experts in the field of intraabdominal
adiposity that will be recorded
and offered on the website. This is a
new and evolving field, and I think that,
because of the prevalence of obesity out
there—in particular abdominal obesity—
this is going to be a really hot area on our
website. There is a lot of discussion about
the role of intra-abdominal adiposity in
triggering blood sugar abnormalities and
blood cholesterol abnormalities and we
are really going to focus on how that happens,
but also on what we can do with our
patients to try to make a dent in that.
Has the role of NPs
and PAs in addressing
and treating
the constellation of
cardiometabolic risk
factors changed as
more information
has come to light?
I’m not sure that our role has changed,
but I know that our numbers have
changed; and because of that, we are
providing a significant percentage of
primary care in this area. There are
200,000 advanced practice clinicians
right now, and we outnumber practicing
family physicians. It has been predicted
that we will eventually be providing the
vast majority of primary care, and if obesity
is kind of the incident or condition
that sets that whole cascade of events
in place, then what we need to do is
go back and really target obesity as a
disease state and not really a behavioral
flaw, which is what a lot of people in this
country perceive it to be.
What kind of information will users find
in the “Therapeutic Resources Area?”
In the “Therapeutic Resource Area” we
have included articles and information
pertaining to different disease states
that have been published by clinical
journals such as Journal of Family
Practice, Current Psychiatry, OBG
Management, and others. The articles
are organized around 25 topics and
disease states, including addiction/substance
abuse, cancer, cardiovascular
disease, diabetes, and obesity. If a
nurse practitioner is looking for information
on obesity, for example, he or she
can go to APCToday.com, click on the
“Therapeutic Resources Area,” and see
what’s been published recently regarding
that topic and quickly find information.
Do visitors to APCToday.com have to
register to access all the information and
resources that are available?
It is available to everybody who visits
APCToday.com, but people who do
register will receive an e-mail editorial
from me once a month, and with that
e-mail will come eight different articles
from leading clinical journals that I will
have reviewed and chosen as premier
articles that I think are very important to
NPs, PAs, midwives, and clinical nurse
specialists. Highlighting those articles
will serve as a reminder that we’ve introduced
new information on APCToday.com
and prompt the recipients to come back
and visit our site again.
In addition to the resources that you
have already talked about, is there anything
visitors can look forward to in the
coming months on APCToday.com?
I would just encourage advance practice
clinicians and other healthcare
professionals to come visit the site,
because we are always engaging in a
dialog with our readers. We hear from
them regarding what resources they
like and what they hope we add or
change in the future. We are constantly
looking to update the site with information
and content that crosses all
different domains. We anticipate doing
some work on malpractice and malpractice
prevention, which is a very hot
topic for clinicians. We will continue to
address relevant professional issues
for our audience and strive to be the
premier online source for advance practice
clinicians.