In high school, Carl Laffoon had dreams of being a doctor. He started working as a paramedic, and before long was married with children. It was 20 years before Laffoon, in 2007, opened his own family practice/urgent care clinic in Tuttle, where he and two other providers see about 6,000 patients from Newcastle and Bridge Creek to Minco, Moore and south Oklahoma City.
Laffoon never became a doctor. He’s a nurse practitioner, a registered nurse who holds master’s and doctorate degrees in advanced nursing. Oklahoma allows nurse practitioners to treat and diagnose patients, order tests and prescribe medications without collaborating with a physician. Most work with doctors in physician offices or hospitals, but they, like Laffoon, can work independently in almost any field, including family practice, pediatrics and women’s health. With health care reform — and the anticipated influx in 2014 of about 50 million previously uninsured patients — nurse practitioners are expected to fill a key role in aiding time-stressed doctors as physician extenders. According to the Oklahoma State Medical Association, the state already is short about 400 family physicians, while the shortage nationwide is expected to nearly triple to 46,000 by 2020. With rising malpractice insurance and lowered government reimbursements, fewer pursue medicine and most who do go into specialties or surgery to earn more, studies show. "As a primary care health provider, I see results,” said Laffoon, who worked years as an emergency/critical nurse and as a hospital executive. "Patients present with hypertension, high cholesterol and diabetes that was never diagnosed, and we can follow the standards of care and actually get it under control, and that feels good.