Sarah Kliff looks at a campaign by the American Academy of Nurse Practitioners to expand the number of medical procedures they are allowed to perform.
The issue here is that different states have different “scope of practice” laws that determine the level of training necessary to perform a procedure.
For instance, some states require a dentist to be in the room when a dental hygienist cleans your teeth. Naturally this makes teeth cleanings much more expensive. It also means that a hygienist can’t just open a walk-in teeth cleaning practice in a low-income neighborhood, because she’d need to have a dentist on-site, and this would make the service prohibitively expensive for a lot of people.
This is one of the reasons American health care is so expensive. Incumbent service-providers are constantly adding to the list of jobs you need state approval to do, and this is pushing up prices. We could have much cheaper primary care in this state if we increased the number of procedures that nurse practitioners could perform, which would be great for nurse practitioners and great for middle class and lower income consumers of medical care:
The campaign looks to exploit what many say is a looming doctor shortage. The Association of American Medical College predicts that the country will have 63,000 too few doctors as soon as 2015.
“With the serious shortage of family doctors in many parts of the country, nurse practitioners — or NPs as they are known — can provide expert, compassionate and affordable care,” the group will contend in a radio public service announcement.
The AANP will follow up on the public relations blitz with state-level lobbying efforts, looking to pass bills that will expand the range of medical procedures that their membership can perform.
“A fully enabled nurse practitioner workforce will increase access to quality health care, improve outcomes and make the health-care system more affordable for patients all across America,” Jensen said.
All states have “scope of practice” laws, which regulate what medical procedures each profession can, and cannot, perform, given their level of education. These laws regulate everyone from dental hygienists to physician assistants up to nurse practitioners, who all hold graduate degrees in medical education.
In 16 states, nurse practitioners can practice without the supervision of another professional such as a doctor. Other states, however, require a physician to sign off on a nurse practitioner’s prescriptions, for example, or diagnostic tests.
As the health insurance expansion looms, expanding those rules to other states has become a crucial priority for nurse practitioners. “We’re all educated and prepared to provide a full range of services,” said Taynin Kopanos, AANP’s director of state government affairs.