AMA: Nurses aren't our equals

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The American Medical Association was quick to respond to yesterday's Institute of Medicine report that called for nurses to take on a larger, more independent role in transforming healthcare in America. By 2 p.m., it had shot out a board member's response to media outlets. Its main message: Nurses are not equal to physicians. Besides reinforcing the importance of a physician-led team approach, the statement underlined the difference in education and training between nurses and physicians.

The statement issued by Dr. Rebecca Patchin, an AMA board member, notes, "Nurses are critical to the healthcare team, but there is no substitute for education and training." She goes on to compare physicians' seven or more years of postgraduate education and more than 10,000 hours of clinical experience with nurse practitioners' two to three years of postgraduate education and less clinical experience than that of a first-year medical resident.

It's possible the physicians fear the report's proposals could lead nurses encroaching on their turf and reimbursements. The Institute of Medicine report recommends that CMS reimburse advanced practice nurses--such as nurse practitioners and anesthetists--at the same reimbursement level as physicians, and calls on the FTC to ensure state laws do not overly restrict nurses' scope of practice.

Not surprisingly, Dr. Marla Weston, CEO of the American Nurses Association, told FierceHealthcare that her group was pleased with the report's recommendations. In response to the AMA's comments, she noted that the IOM report was evidence-based and that decades of research show that advanced practice nurses can function independently as primary-care providers.

She argued against limiting their practice to whatever could be supervised by physicians. "If an advanced practice registered nurse in a rural community is willing to provide care and a physician is 200 miles away, then we've just cut off access to primary care in that community," she said. "We're not using nurses to the full extent. They are an untapped resource."

To learn more:
- read the Institute of Medicine report
- see the American Medical Association press release
- read the Becker's Hospital Review article

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