By Joy Elwell
Nurse practitioners are expert health professionals who are nationally licensed and credentialed to provide autonomous primary care services.
However, 33 states, including New York, impose arbitrary restrictions on their authority.
Specifically, New York requires that nurse practitioners have collaborative agreements with physicians to diagnose, treat and prescribe medications or tests – an unnecessary bureaucratic hurdle that delays care. This problem will only get worse when millions of patients join the rolls of the insured as part of national health care reform.
To meet the needs of patients in Buffalo and across New York, we must ease restrictions on nurse practitioners, closing the gap between what they are educated and trained to do, and legally permitted to do. Already, 52 out of New York’s 62 counties are federally designated “Healthcare Provider Shortage Areas.” It is estimated that the state needs an additional 12,000 primary care providers to meet current needs. New York has more than 16,000 nurse practitioners licensed and ready to help.
Nurse practitioners undergo rigorous master’s, often doctoral, education and clinical training that equips them to provide high-quality, safe, autonomous care. Their unique preparation is competency-based; students progress only when they have demonstrated mastery of a subject. Their education also focuses on one student-chosen specialty (e.g., pediatrics) from “day one.” This is in direct contrast to medical schools, where a student studying to be a pediatrician would earn credit for time spent learning specialties outside pediatrics.
Nurse practitioners are also more likely to stay in primary care. Thus, nurse practitioners frequently serve as the sole primary care providers in rural communities, and among medically underserved and uninsured populations.
Most crucially, 40 years of study has shown the outcomes of nurse practitioner patients are equal to and often better than those of physicians. Patients also frequently report that they prefer nurse practitioners because of the added health education and counseling they offer. In fact, outcomes research has recently shifted from using physicians as the “gold standard,” citing nurse practitioner excellence in primary care and other specialties.
National organizations have increasingly recommended that states grant nurse practitioners full practice authority. These groups have grown to include the National Council of State Boards of Nursing, the Institute of Medicine and, most recently, the National Governors Association.
It is time for New York State to follow suit and embrace this common sense, zero-cost solution. It is in the best interest of patients, which is far more important than any turf war between providers.
Joy Elwell is Region 2 director for the American Association of Nurse Practitioners.