A dedicated nurse practitioner clinic could open in the Illawarra within six months under major federal healthcare reforms announced last year.Access to the Medicare Benefits Scheme and Pharmaceutical Benefits Scheme (PBS) became available to nurse practitioners for the first time last week.The move enables nurses to provide patients with Medicare subsidised services and PBS-subsidised medicines.In effect, they are now able to write prescriptions, make referrals to specialists and send patients for scans - all previously the preserve of doctors.More nurse-led clinics are likely to emerge where nurse practitioners work autonomously, although they are still required to have a formal collaborative agreement with a doctor.The Revive Clinics chain, which runs eight nurse-led outlets across Australia, is looking at a potential site for a clinic in the Illawarra and said preliminary research had indicated there was demand for services."We've been approached by pharmacy owners (in the Illawarra) who would like to have their own Revive Clinic," said director Louise Stewart.If the clinic goes ahead, she expects it to be up and running in the next six months.However, Illawarra Division of General Practice chair Dr Russell Pearson said he had reservations about nurse practitioners seeing patients in a setting not supervised by a GP."I think it's a model being developed because it's a successful model perhaps in rural and remote areas," Dr Pearson said."I don't know whether it's needed in regional Australia in the same way ... I don't think there's a big place in the Illawarra for it and I'd much rather see nurses in primary care working in multi-disciplinary teams."Dr Pearson said he was a strong advocate for inter-disciplinary teams delivering healthcare in the general practice setting, with doctors working alongside professionals such as practice nurses, nurse practitioners, dieticians, and exercise physiologists.He said while monitoring and measuring aspects of health can be delivered by such a team, the importance of a doctor should not be underestimated."The doctor has a place in listening to the patient history, conducting a physical examination and arriving at an appropriate diagnosis," Dr Pearson said."There are some skills specifically and uniquely taught to doctors ... a nurse practitioner is the next best thing in a remote area but if you've got a doctor available, the public are better served by having a doctor and nurse working together and having that symbiotic relationship."Dr Mark Condon of Albion Park Medical Services has been trying to attract a nurse practitioner to his team for more than a year.He said they were a valuable asset for general practices, assisting in the management of chronic diseases such as diabetes and alleviating pressure on GPs."Having nurse practitioners able to sign scripts and referrals would save GPs running round like mad men," he said.But he has concerns about nurse practitioner clinics operating outside of a general practice.He said nurse practitioners working away from general practices posed a danger of patient care becoming too fragmented."It works if their scope of practice is very well defined," Dr Condon said.