Health Care Experts Weigh in on Reform Debate and New Cancer Screening Guidelines

Primary care nurses and nurse educators at Pace University’s rapidly-growing Lienhard School of Nursing have informed views on the current news about healthcare reform and guidelines for breast and cervical cancer screening.


Contact: Sharon Lewis, Lienhard School of Nursing, (914) 773-3973, Cara Cea, (914) 906-9680,



Nurse practitioners best group to handle increasing need for primary care, says dean of nursing school; Nursing practice should not change yet, say Pace University experts

PLEASANTVILLE, NY, December 2009 – Primary care nurses and nurse educators at Pace University’s rapidly-growing Lienhard School of Nursing have informed views on the current news about healthcare reform and guidelines for breast and cervical cancer screening.

All can be reached directly at the numbers below as well as through media contacts above.

Nurse practitioners are ready to meet increased demand for primary care: Harriet R. Feldman, PhD, RN, FAAN

Dean of the Lienhard School of Nursing at Pace University, Feldman has emerged as a national authority on three major trends that are changing the nursing profession – the shortage of nurses and nurse educators, the involvement of nurses in promoting health policy, and the promotion of evidence-based procedures in education and nursing practice. With a PhD in nursing science from New York University, she has published more than 90 books, chapters and articles and testified before Congress. Her school’s enrollment is up this fall by about 80 students, the fourth year with such an increase; in recent years the school has been awarded over $5 million in federal and private grants. Lienhard’s Family Nurse Practitioner Program is ranked ninth nationally in the U.S. News & World Report survey of “America’s Best Graduate Schools 2008;” last year the school added a doctor of nursing practice program. Feldman is on US Representative Nita Lowey’s (D-NY) Health Advisory Committee and a Fellow of the American Academy of Nursing and of the New York Academy of Medicine. Feldman is also the 2009 chair of the Board of Commissioners of the Commission on Collegiate Nursing Education (CCNE), the national nonprofit agency that exclusively accredits baccalaureate and higher degree programs in nursing.

Feldman says: “A major tenet of the proposed Health Care Reform legislation is to expand primary care delivery to focus on health promotion and maintenance and the management of chronic illness. The current plan very properly envisions using nurse practitioners to meet the increasing need and I cannot think of a more appropriate group of professionals.

With a focus on preventive care, nurse practitioners have been delivering primary care in a variety of inpatient, outpatient, and community settings in for over 40 years. While primary care physicians’ numbers are down 30%, the number of programs preparing nurse practitioners has been increasing annually in recent years to meet growing demand and expand the nursing workforce. There are now 323 programs that prepare students to join the workforce of 2.9 million nurse practitioners.” Nurse practitioners are registered nurses with advanced preparation and qualified to prescribe medication.

Harriet R. Feldman, PhD, RN, FAAN Dean and Professor, Pace University Lienhard School of Nursing Interim Dean, School of Education Phone: (914)-773-3342 Fax: (914)-773-3480 Email:

Don’t move too fast: Andrea Sonenberg, NP, CNM, DNSc

Assistant Professor Andrea Sonenberg, a nurse practitioner and certified nurse midwife with a doctorate from Columbia, is an expert in women’s health and in the regulation of advanced nursing practice and global use of Advanced-Practice Nurses (APNs) for vulnerable populations.

Sonenberg thinks it would be premature for APNs to change their cancer screening practices yet. She also recognizes that throughout history, periodic changes in guidelines for breast self-examination and the use of PAP smears have taken place as new evidence was uncovered and weighed by expert panels and organizations, and that these changes are always informed by dialogues beginning prior to their announcements.

She stresses that recommendations that may be made by the US Preventive Services Task Force (USPSTF) will be directed at routine screening schedules for low risk women. “Each provider must determine a client’s risk individually,” Sonenberg says.

She adds: “The fact that the USPSTF has a different membership than it did when the previous recommendations were made seven years ago is less relevant, in my view, than the fact that there is new evidence on which to base revised recommendations.”

On health care reform: “I would also like to caution against trying to link these new recommendations to the health care reform debate. I believe the timing is coincidental. Review of evidence by USPSTF is ongoing. Some believe that these recommendations are meant to save money for insurance companies, and therefore the health care system on the whole. It worries me that this belief could spread and lead us down a dangerous path regarding primary care and prevention.”

Andrea Sonenberg, NP, CNM, DNSc Assistant Professor, Pace University Lienhard School of Nursing 861 Bedford Road Pleasantville, New York 10570 Phone: (914) 773-3534 Fax: (914) 773-3345 E-mail:

Still recommending mammograms: Audrey Hoover, MS, RN, FNP, WHNP

Audrey Hoover, MS, RN, FNP, WHNP, a family nurse practitioner who specializes in family and women’s health, is also taking a cautious approach to breast cancer screening and will carefully weigh all the information before changing her practice. She says, “This is very new data…. we are continuing to recommend mammograms for women at 40.”

Regarding PAP smears, Hoover recalls the overzealous screening and treatment of adolescents a few years ago that turned out to be unnecessary. Human papillomavirus (HPV) may increase the risk for cervical cancer and for abnormal PAP smears in certain women, depending on age. “We now know that he HPV virus tends to clear by about age 26,” says Hoover. “Early data analysis on the virus and recommendations on the treatment for it were premature.” Hoover is considering recommending new American College of Obstetricians and Gynecologist guidelines for PAP smears every two years starting at age 21, and every three years after age 30 for women who have had three consecutive negative PAP smears.

Hoover is associate director of University Health Care at Pace University which offers a full range of primary care services to the Pace community.

Audrey P. Hoover, FNP Family Nurse Practitioner and Associate Director Pace University Health Care NY Campus 41 Park Row, Rm 313 New York, NY 10038 Phone: 212 346-1600 Fax: 212 348-1308 E-mail:

About Pace University: For 103 years Pace University has produced thinking professionals by providing high quality education for the professions on a firm base of liberal learning amid the advantages of the New York metropolitan area. A private university, Pace has campuses in New York City and Westchester County, New York, enrolling nearly 13,000 students in bachelor’s, master’s, and doctoral programs in its Lubin School of Business, Dyson College of Arts and Sciences, Lienhard School of Nursing, School of Education, School of Law, and Seidenberg School of Computer Science and Information Systems.

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