Do nurses want to be doctors? Of course many do.

And I say, if you want to be a doctor, go to medical school. I say that as a red-blooded, licensed, board-certified, AMA card carrying, guild mentality, protectionist physician.

But I am also a citizen, a patient, a taxpayer, a public health professional, and a member of the Institute of Medicine (IOM) of the National Academy of Sciences.

The IOM has recently issued a very controversial report entitled The Future of Nursing: Leading Change, Advancing Health.

You nurse readers are going to love this report; many of you physician readers may not. It may curl your hair, in case you have any left.

According to the October 2010 IOM press release:

“Nurses’ roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by healthcare reform and to advance improvements in America’s increasingly complex health system. … Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States, said the committee. … To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor’s degree to 80 percent by 2020, and double the number who pursue doctorates. … Regulatory and institutional obstacles — including limits on nurses’ scope of practice — should be removed so that the health system can reap the full benefit of nurses’ training, skills, and knowledge in patient care.”

How about that? Do you see some state legislative battles coming up?

Of course, mainstream physician and organized medicine influence within that committee was sparse. But let’s face it. If this means that primary care can be rescued by physicians, physician assistants, and nurses (so called “Noctors”) working together, so be it.

For a wide variety of reasons, primary care by U.S. MDs is threatened with extinction.

And the demise of primary care would be really bad for the country and its inhabitants.

George Lundberg is a MedPage Today Editor-at-Large and former editor of the Journal of the American Medical Association.

Originally published in MedPage Today. Visit MedPageToday.com for more primary care news.