Candidate Corner

Expanding Scope of Practice for Nurse Practitioners


Posted by Anonymous at 10/30/2017 1:15:34 PM

The Demand for NPs is Growing


Expanding Scope of Practice for Nurse Practitioners

By Doug Bennett, Contributor


After passage of the Affordable Care Act the demand for access to preventative and primary care has never been greater. Nearly 18 million Americans have gained insurance coverage. In underserved rural and urban areas the need for healthcare is amplified due to massive shortages of primary care physicians. Surveys indicate that over 58 million Americans live in areas experiencing a shortage of primary care physicians. Despite this circumstance, advanced nurse practitioners (NPs) must continue to fight for the right to prescribe controlled substances and operate practices without a collaborative agreement with a physician.


Some states are addressing this historic chasm between need and availability by enabling nurse practitioners to provide preventative care and, thereby, help Americans stay healthier. Expanding scope of practice for nurse practitioners would allow them to order tests, diagnose patients, initiate involuntary psychiatric commitment for unstable patients, complete death certificates, and, in general, perform procedures, actions and processes based on their education and training.


Greater availability of nurse practitioners providing preventative care can reduce the number of people who forego primary care and the number of people seeking treatment for preventable conditions in emergency rooms throughout the country. And, studies repeatedly show that enhanced access to primary care reduces costs and increases the quality of patient outcomes. Quality of care improves because NP’s can spend more time with patients than primary care physicians, which enables them to offer more detailed guidance and instructions on how to address each patient’s particular health challenges.


Nurse practitioners are projected to experience 31% job growth between 2017 and 2024. This trend is likely to gain momentum as more and more states recognize the significant expertise NP’s bring to the table. Many states have already passed or introduced legislation to loosen longstanding restrictions and grant more autonomy to nurse practitioners. Some state legislatures are even introducing bills that will allow nurse practitioners to prescribe controlled substances without the oversight of a physician. When more nurse practitioners are able to function independently and can manage a host of preventative care needs, more Americans enjoy increased access to care.


The Veterans Administration made a historic move in January 2017 by granting full practice autonomy to certified nurse practitioners, certified clinical nurse specialists and certified nurse midwives. In addition to increasing access to care, this policy change saves money for NP’s—who no longer are required to pay significant monthly fees for physician oversight—as high as $3,000—as well as for states which can decrease monitoring and enforcement regulations. This unprecedented step by the VA has created momentum for nurse practitioners and their advocates around the country.


Many physician groups oppose the expansion of nurse practitioner scope of practice, citing concerns about impacts on overall quality of patient care and over-referral to specialists; however, studies show that the quality of patient care is comparable between physicians and nurse practitioners, and claims that NP’s increase patient use of specialists are unsubstantiated.


Nonetheless, restrictive practice laws continue to persist in some states,—especially in the Southeast and mid-Atlantic—and the slow pace of change continues to frustrate nurse practitioners and their advocates. Organized medicine groups have spent a great deal of time and resources raising questions, concerns and doubts with policymakers and the public about the abilities and qualifications of nurse practitioners.


Despite the opposition of physician groups, a number of states have granted greater leeway to nurse practitioners to practice primary care. For instance, at least 21 states have revised their laws to grant nurse practitioners full practice and prescriptive authority, including Vermont, Maryland, Minnesota, Nebraska, Nevada, Rhode Island, North Dakota and Connecticut in recent years. Other states, such as Texas, Utah, New York, Kentucky, Wisconsin and Arkansas have recently expanded the scope of practice for nurse practitioners.


Let Merritt Hawkins help you find the perfect physician or advanced practitioner job today. Discuss your career ambitions and lifestyle choices with our highly experienced recruiters who can help you find new opportunities that will make your physician and advanced practice career sizzle with new experiences.





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