Why healthcare must eliminate barriers for nurse practitioners

Increasing numbers of nurse practitioners (NP) who enter the healthcare field could help fill the gap created by a shortage of primary care physicians, according to an opinion piece on the Health Affairs Blog.

Although more Americans are now covered by health insurance and seek medical care, the number of primary care physicians entering the field has remained relatively flat over the past three years, according to authors Joanne M. Pohl, Ph.D., professor emerita at The University of Michigan School of Nursing; Deborah J. Barksdale, Ph.D., associate professor and director of the Doctor of Nursing Practice program at the University of North Carolina at Chapel Hill; and Kathryn (Kitty) E. Werner, executive director of the National Organization of Nurse Practitioner Faculties. At the same time, the number of NPs graduating and entering the healthcare field has increased.

The National Center for Health Workforce Analysis predicts that by 2020 the country will face a shortage of primary care physicians as high as 20,400.

The authors wrote that it's time to eliminate the barriers to NPs so they can practice to the fullest extent of their training and they can fill the gap left by the shortage. Currently 21 states and the District of Columbia allow NPs to practice fully under their own licenses without requirements for supervision and other states have legislation pending to expand the scope of practice for NPs. Nebraska expanded the role of nurse practitioners earlier this year.

"The unnecessary requirements in numerous states for physicians to sign orders for physical therapy or other referrals, supervise NPs, or sign off on numerous other documents are costly, waste precious physician time, and are not feasible in the real healthcare world," the authors wrote.

Regulations that support a patient's access to NPs are essential to meet the demand for medical care, they said. Expanding NPs ability to practice independently will help provide care in rural areas where access to healthcare is often more problematic, but physician groups are often opposed to those efforts.

To learn more:
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