More states expand authority for advanced-practice nurses

More and more states are jumping on the bandwagon of expanding the role of advanced practice registered nurses (APRNs) to improve healthcare outcomes and make up for the looming physician shortage.

Lawmakers in Minnesota recently passed a law that gives APRNs the authority to diagnose and refer patients, order tests and write prescriptions, according to a report from Minneapolis radio station KARE11.

A similar bill that originated in the Michigan state senate is currently stalled in the state's House Health Policy Committee, according to an opinion piece penned by Bret Jackson, the president of the Economic Alliance for Michigan, and published in Crain's Detroit Business.

In urging the bill's passage, Jackson writes that the "way to meet the primary care demand is by allowing nurse practitioners the ability to diagnose and treat patients without direct physician supervision."

"Passing [the bill] will contribute to the continued growth of Michigan's economy, keep healthcare costs in check and increase primary care options," he concluded.

Michigan and Minnesota aren't alone: Kentucky enacted a law in February to allow APRNs limited prescription-writing powers, while an audit conducted in January in West Virginia recommended an expansion in the scope of care APRNs are allowed to perform, FierceHealthcare previously reported.

But the trend is not without its critics--with some dissent often coming from doctors themselves.

"We put such a high standard on patient safety that unless we can absolutely say that something is going to work, we don't recommend it," Will Nicholson, M.D., a Health East family practice doctor and member of the Minnesota Medical Association, told KARE11 in reference to Minnesota law.

And when Legislative Auditor Aaron Allred recommended that West Virginia expand the scope of APRNs' care, he cautioned that nurses shouldn't be allowed to operate independently from physicians.

"Given the addiction crisis we have in West Virginia, I cannot in good conscience recommend to the Legislature that 2,149 more individuals in West Virginia be allowed to write prescriptions for Class 2 narcotics," he said, as FierceHeatlhcare previously reported.

A far-reaching 2011 study conducted by Johns Hopkins School of Nursing, however, found that nurse practitioners, certified nurse midwives and clinical nurse specialists produce patient outcomes on par with--and in a few cases even better than--physicians, according to FiercePracticeManagement. These findings, as well as other reports that indicate using APRNs is critical to cut costs and make up for the physician shortage, have led some to call for more equality in regard to doctor and advanced practitioner pay.

To learn more:
- read the KARE11 report
- read the Crain's opinion piece

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