Nurse practitioners can improve outcomes, lower healthcare costs, and expand patient access to care. But only if their practice environments let them.
It's not news that the US is facing a shortage of primary care physicians.
According to estimates by the U.S. Department of Health and Human Service's Health Resources and Services Administration, by 2020 the nation will by facing a shortage of 20,400 primary care physicians.
The good news is that the organization predicts this gap in primary care could potentially be filled by nurse practitioners and physician's assistants.
The number of primary care NPs is expected to increase by 30% (from 55,400 in 2010 to 72,100 in 2020) and the primary care PAs is projected to increase by 58% (from 27,700 in 2010 to 43,900 in 2020).
Annual Number of Graduates from NP Programs: Master's and Post-Master's Graduates, 2002 Through 2012
As Cindy Cooke, DNP, FNP-C, FAANP, president of the American Association of Nurse Practitioners points out there's more to solving the primary care provider shortage equation than simply balancing less with more.
Scope of practice and licensing issues also need to be addressed. The AANP (source of map below) tracks practice environments.
"Alabama is a collaborative state and I actually worked for the military, so it's a federal property where I can practice to the full scope of my education and training. But as soon as I drive outside of those states, I'm not smart-enough, apparently, to do it again," Cooke says.
"To me it's a terrible waste of people. We have the expertise and let's utilize it. The patients are suffering. Access to care is huge."
Cooke believes there are three major reasons that healthcare leaders should support full practice environments for NPs.
1. NPs Can Improve Patient Outcomes
As an example of how NP's can impact patient outcomes, Cooke points to the results Judith Kutzleb, RN, DNP, CCRN, CCA, APN-C, vice president of advanced practice professionals at Holy Name Medical Center, in Teaneck, NJ, has seen with her model of care delivery, The NP Care Model.
After implementing the model, Kutzleb saw a drop in heart failure patient's 30-day readmission rates. They fell to 8% from 26% over a 12-month period.
Related: NP Care Model Drastically Lowers Heart Failure Readmissions
"To me that is a perfect of example of how we can really, truly effect change, how can we improve outcomes, how can we decrease admissions, and how can we really attack a problem before it becomes big," Cooke says.
"In hospitals across the nation, whether they have heart failure clinics or whether it's a critical access hospital, I see NPs in those roles because they're there to meet the needs of the patients."
2. NPs Can Expand Access to Care
Recent research from nurse economist and Montana State University professor Peter Buerhaus
has found that NPs are more likely than medical doctors to work in rural areas.
But in order to meet the needs of these underserved patients, NPs need to be allowed full practice.
"If it's a collaborative or supervisory state, and let's say a physician decides to retire or gets sick or dies or tries to leave the practice urgently... Then that NP cannot practice period," Cooke says.
"And so to me, the patients are left without, they're hung out to dry, and they've got to find a new provider, especially in underserved areas."
3. NPs Help Contain Costs
Because they're trained to "partner" with patients to improve their health, NPs have the ability to help contain healthcare costs, says Cooke.
"What we have now is a sick care model of health care," she says.
"We always say we're our patients' partner in health. How do we motivate our patients to be active participants in their own healthcare? To me that is a collaboration, a working together in promoting health and that to me is a way to help in hospital costs and to help in so many ways."
Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.