Advanced nurse practitioners and GPs: what is the difference?

In primary care, a crossover of role boundaries between GPs and advanced nurse practitioners (ANPs) has led to a lack of role definition. This article analyses the findings from a study that attempted to define the distinctiveness of the ANP and GP roles. Two ANPs and two GPs from a training practice took part in the study. Consultations were recorded, transcribed and analysed using a qualitative methodology. Patient conversations were divided into six phases of the consultation: opening; history-taking; physical examination; diagnosis; management; and closing. Practitioner–patient interactions and behaviour were examined in each of the phases. Two typical extracts are highlighted: one between a GP and patient, and the other between an ANP and patient. ANPs interwove expert nursing skills throughout each interview, making their nursing identity clearly visible to patients. This study identified that GPs work in a different style to that of nurses, with ANPs working to diminish social distance from patients rather than creating it; this positions ANPs more in line with nursing than with medicine.