“The major motivation in this opposition is kind of a turf war,”
says Dale Ann Dorsey, a nurse practitioner (NP) who runs her own
women’s health clinic in Scottsdale, Arizona.
A nurse practitioner is a registered nurse (RN) who has pursued
extra clinical training and a master’s degree and is able to
practice medicine beyond the scope of what a regular RN can. How
far beyond that scope NPs should be allowed to go is a question
facing legislators across the country.
Arizona is one of 18 states that allow nurse practitioners to
run independent primary care practices, with full prescribing
privileges, and without the oversight of a licensed physician.
Earlier this year, nurse practitioners in California pushed to
liberalize scope-of-practice rules in the Golden State, only to be
stopped dead in their tracks by the powerful California Medical
Association (CMA), which
poured more than $1 million into lobbying efforts in the first
half of 2013 to defeat the legislation.
“[Nurse practitioners’] training is very limited compared to
physicians,” says Paul Phinney, a California pediatrician and
former CMA president. “They lack a certain kind of experience that
I believe is very important to the safety of patients and the
quality of medical care that they’re providing.”
He has a point. Physicians are required to obtain far
more education and clinical experience than are nurse
practitioners. But there’s little to no evidence showing that, when
it comes to primary care, all of that extra education makes any
difference in the health outcomes of patients. A 2012 Health
Affairs survey of the medical literature found
no difference in patient health between groups treated by
doctors and by nurse practitioners. The survey did find a slightly
higher satisfaction rate among patients of nurse practitioners.
So if outcomes are similar, and patients are satisfied, why are
states such as California hesitant to let more nurses open their
own practices? The question is especially pressing since groups
such as the Association of American Medical Colleges are
expecting a severe doctor shortage in the near future due
to the aging population. Reason Foundation analyst Adam Summers
says that concern for the public good is a secondary consideration
at best in this case.
“Licensing laws are almost always sold as being in the public
interest,” says Summers. “But in reality all they do is drive up
prices and reduce competition, which reduces the incentive to
provide good services to the consumer.”
Watch the video to learn more about the nurse practitioners’
struggle for clinical independence – a fight that just make health
care cheaper and more available.
Click the link below for downloadable versions, and subscribe to
Reason TV’s YouTube
channel for daily content like this.
Approximately 5 minutes. Produced by Zach Weissmueller. Shot by
Tracy Oppenheimer and Weissmueller. Graphics by William Neff.
from Hit & Run http://reason.com/blog/2013/12/03/nurse-practitioners-can-make-health-care