New research indicates that fears about expanding the role of nurse practitioners(NPs) for primary care may very well be unfounded. In fact, the data suggests full practice NPs can create better patient outcomes when compared to the outcomes in states where full practice NPs are not allowed.
Researchers conducted their study by looking at Medicare and Medicare-Medicaid recipients and how they fared in the healthcare delivery and patient outcome arenas. They looked at things such as hospitalization rates, readmissions, nursing home resident hospitalizations, and avoidable hospitalizations. Among the key findings are the following:
- There were just over 100 avoidable hospitalizations per 1,000 patients in states allowing full practice NPs.
- There were more than 145 avoidable hospitalizations per 1,000 patients in states where full practice NPs are not allowed.
PCNP Executive Director Susan Schrand has said that the newly released research is just the latest in a mountain of evidence showing equal or better outcomes when NPs are allowed to provide all primary care services independent of doctor supervision. She said there are at least 100 studies making the case that full practice NPs should be the norm nationwide.
State-by-State Debate
The current environment for nurse practitioners varies from state to state, creating a state-by-state debate over whether or not these medical professionals should be given autonomy for primary care. At the heart of the matter is a single objection from doctors: nurse practitioners do not have the same amount of experience. It turns out that such experience is the only thing lacking.
NPs hold either a doctorate or master's degree. They have received much of the same training as a primary care physician, and they are capable of diagnosing and treating at nearly every level of primary care. Proponents of full practice NPs believe that the training and licensure requirements for NPs qualify them to provide primary care independent of doctor supervision. In states where it is already allowed, significant numbers of NPs are being employed by neighborhood pharmacies or opening their own private practices.
Patient Response
As for how patients respond to nurse practitioners, some groups of patients, particularly older people, seem to be more willing to accept nurse practitioners in place of physicians because they give patients more time and personalized service. While many patients say they would prefer a physician over a nurse practitioner, when presented with the option to wait for a physician or to be seen immediately by an NP or another healthcare professional, most choose not to wait. Also, Americans seem largely in favor of allowing NPs to provide more healthcare services without supervision.
Only a Matter of Time
In an environment in which healthcare demand is rising rapidly, the modern nurse practitioner is going to be an important part of moving American healthcare forward. The more the demand for primary care exceeds the supply of available physicians, the more healthcare consumers and regulators will accept the role nurse practitioners can play in meeting the basic healthcare needs of the nation.
Sources:
- The Express – http://www.lockhaven.com/page/content.detail/id/558299/Study--Nurse-practitioners-making-a-difference.html?nav=5168
- Forbes - http://www.forbes.com/sites/brucejapsen/2013/06/04/patients-warm-to-nurse-practitioners-physician-assistants/
- American Association of Family Practitioners -http://www.aafp.org/news/practice-professional-issues/20131218ipsossurvey.html
- American Association of Nurse Practitioners - http://www.aanp.org/press-room/press-releases/136-press-room/2013-press-releases/1389-new-poll-shows-strong-public-support-for-greater-access-to-nurse-practitioner-care
