Alternative health care delivery systems--nursing opportunity or threat?

Alternative health care systems, organizationally and financially, pose a potential threat to the growth of autonomous nursing practice. Support of a system of health care delivery that retains the physician as sole "primary provider" restricts direct access to professional nursing services. Nurses must take the responsibility for becoming knowledgeable about health policy-making in order to assure that their services remain available to all consumers who seek them. This article presents an overview of the current alternative health care systems, and suggests strategies to assure that nursing does not remain in a dependent position in the hierarchy of health care.