Abstract
Recent Nebraska legislation has relaxed regulations on the scope of practice for nurse practitioners (NPs) in an attempt to reduce the healthcare provider shortage. This move centered on the idea of NPs operating rural primary care clinics without the previously limiting oversight of a medical doctor. A medical anthropological approach to assessing this legislation’s impact requires the study of cultural preferences for the patient-provider relationship in Nebraska. While medical anthropology has studied patient-provider relationships, further study is required in rural areas to assess local populations for preferences in different types of healthcare providers. The trend toward greater NP utilization is one example of an increasingly important patient-provider relationship. Therefore, the patient-provider relationship needs to be reassessed on the local level for cultural norms and expectations influencing this relationship. In this study, a mixed-methods approach was taken to assess the local perceptions of NPs and the patient-provider relationship utilizing a quantitative survey and qualitative interviews of patients at a NP-run clinic in Elk Valley, Nebraska. In this setting, the following variables arose from the interview process and were assessed for their impact on the development and maintenance of the patient-provider relationship: 1) Provider credentials and perceived competency, 2) Trust, 3) Provider actions, 4) Provider characteristics, and 5) Perceptions of health and wellness. A lifeworld perspective of these variables influenced by the work of Jürgen Habermas allows for the discussion of subjective, societal, and objective interpretations of the patient-provider relationship.