Expand nurse scope of practice to cut costs, improve access

As the physician shortage widens and healthcare costs soar, the industry is hearing more calls to increase the role of advanced practice nurses (APRN).

Even though giving nurses primary care authority will increase coverage and lower costs, the concept still is facing opposition from physicians, John Rowe, a doctor and health policy and management professor at the Columbia University Mailman School of Public Health, wrote Monday in The Atlantic.

He cites the "turf war" between various provider groups as a main barrier to increased APRN utilization. For example, after a 2010 report from the Institute of Medicine recommended nurses take on a larger, more independent role in transforming healthcare, the American Medical Association responded, stating that nurses are not equal to physicians.

Rowe also notes that physicians are concerned about losing income, as well as their rank as "captain of the ship."

But according to a study published in the 2012 edition of Nursing Research and Practice, increasing the scope of advanced practice nurses does not hurt physicians' earnings. Researchers with the George Washington University School of Public Health and Health Services found no significant differences in wages of primary care physicians in states with more liberal scope of practice laws for nurse practitioners compared to states with more restrictive laws, FiercePracticeManagement reported last month.  

Thirty-four states have scope of practice limitations in place, according to The Atlantic.

In addition to wage stability, improved care quality could get physicians on board with nurse scope-of-practice expansions. Research last year found that care delivered by advanced practice nurses is just as safe and effective, if not more so, than that provided by physicians.

For more:
- read the Atlantic article
- here's the Nursing Research and Practice ­study