Q&A with With Wendy L. Wright, MS, RN, ARNP, FNP, FAANP, Editor-in-Chief of APCToday.com

FOCUS Cardiometabolic Risk, August 2007, Volume 1, Issue 1

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.