Medical EducationPolicy & Law

Nurse Practitioners Can Take Some of the Pressure Off Doctor Shortage

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I know there are some states that seem to regard nurse practitioners with a bit of suspicion, and so their ”scope of practice laws” are quite limiting.


I know there are some states that seem to regard nurse practitioners with a bit of suspicion, and so their ”scope of practice laws” are quite limiting.

In 16 states (Arizona being one of them), NPs can practice without the supervision of a doctor.  The remainder require some physician supervision and it may include signing off on a nurse practitioner’s prescriptions for diagnostic tests.  The University of Colorado holds the distinction of establishing the first nurse practitioner role in 1965.  I think that after 37 years, we can trust them.  And we may need to have them ready to go if the Affordable Care Act is still standing next month because it would expand health insurance to an estimated 32 million people over the next decade.

Sarah Kliff points this out in her post on the Ezra Klein “Wonkblog” on the Washington Post Web site.  The title of the post is “Health insurance expansion looming, primary care turf battle heats up.”

Doctors are often hard to convince that NPs  can and should play a more significant role in primary care.  Since physicians spend more time in training, some of that turf battle is about education, and some of it is centered on concern about patient safety.

Wisely, nurse practitioners are taking their case to the public, rolling out a campaign this week to explain what exactly they do and why patients can trust them with their medical needs.

I have had nothing but positive experiences with nurse practitioners.  30 years ago when my daughter was just coming out of toddler stage, we often saw the NP when we went to the pediatrician’s office.  Since that time, I’ve had the opportunity to see an NP at Urgent Care, and again I felt well taken care of.

Here’s the reality of the situation.  If the U.S. Supreme Court doesn’t put a stake in the Affordable Care Act, we could be as many as 63,000 doctors short just when these 32 million people would have health insurance.  If doctors think they are overworked now, they should consider the pressure they could face in just a couple of years.

The majority of primary healthcare problems are infections, sinusitis, earaches, rashes, and colds – all of which nurse practitioners are more than capable of handling.  They know when to refer patients to a physician, but in the meantime the patients could get more timely care without adding to the patient load of the physician in the practice.  I say it’s time to lift the lid on the antiquated “scope of practice” rules for nurse practitioners.


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