Advance Practice Nurse Solution: Making Healthcare Affordable for All

August 5, 2012
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Despite adding roughly 160k jobs to the economy in July, today’s jobsC report points out that the unemployment rate actually increased to 8.3%.  How can this happen?  According to Morgan Stanley economists David Greenlaw and Ted Wieseman, “…(While) a sizeable portion of the 25,000 rise in the manufacturing sector seems to be related to seasonal adjustment issues, (the) 29,000 rise in the

Despite adding roughly 160k jobs to the economy in July, today’s jobsC report points out that the unemployment rate actually increased to 8.3%.  How can this happen?  According to Morgan Stanley economists David Greenlaw and Ted Wieseman, “…(While) a sizeable portion of the 25,000 rise in the manufacturing sector seems to be related to seasonal adjustment issues, (the) 29,000 rise in the restaurant category is probably reflective of seasonal noise.” Joseph Brusuelas, senior economist at Bloomberg LP, also noted, “The U-6, or what I consider to be the real unemployment rate, increased to 15 percent. This is likely to be a harbinger of things to come, as the unemployment rate inches toward 8.5 percent (when) individuals that have exhausted their unemployment benefits trickle back into the labor market. Consequently, firms (will be) more likely to shed workers due to a slowing economy and to hedge against future risk associated with the coming domestic tax hike and the extended game of policy brinksmanship in Europe over the probable necessity of a Spanish sovereign bailout.”  Not much good news there.

While the national employment outlook appears bleak, there is good news regarding hiring on the healthcare front. The Department of Health and Human Services recently announced that it has awarded five hospitals $200M to help train additional advanced practice registered nurses (APRN). Specifically, the Graduate Nurse Education Demonstration Project will help place nurse practitioners, clinical nurse specialists, certified nurse anesthetists, and certified nurse midwives in critical healthcare delivery roles.  Part and parcel to receiving the grant money, The Hospital of the University of Pennsylvania (Philadelphia), Duke University Hospital Durham, (NC), Scottsdale Healthcare Medical Center (Arizona), Rush University Medical Center (Chicago), and Memorial Hermann-Texas Medical Center Hospital (Houston) have all pledged to support advanced practice nurse training in non-hospital settings such as community health centers and rural health clinics.

While I applaud this historic move to counter the growing primary care physician shortage, I also wonder if this strategy will be successful?  As noted in this timely article in the New England Journal of Medicine, “restrictive state scope-of-practice laws prevent non-physician providers from practicing to the full extent of their training (in 34 of the nation’s 50 states).  Making greater use of these providers would expand the workforce supply, which would increase competition and thereby lower prices.”  A controversial statement at a crucial moment – one has to wonder, will the Advance Practice Nurse Solution – with extended scope of practice – be one of the many innovations necessary to make healthcare once, and again, affordable for all?