Doctors Torn on Nurse Practitioner Practice RegulationsApril 19th, 2013 1 Min read Blog
The AARP recently published a blog titled "Nurse-Practitioners: The Answer to the Doctor Shortage?" While an intriguing question, I think we all know there is not a singular answer, but rather a multitude of factors over years and years that will help America adjust its supply and demand challenges for primary care services. One of the most polarizing issues here is regulation; whether state-controlled laws are giving enough autonomy to NPs to expand their impact. Some doctors question whether they've been given too much already. States vary widely on what the current laws allow. As the Washington Post article puts it: "Maryland is considered almost in this category [of no physician supervision] as well because the state merely requires a nurse practitioner who wants to operate an independent practice to identify a physician to consult if necessary. By contrast, Virginia is among the most restrictive states, with physician oversight required." The article states that if the 14 other states currently (or soon to be) considering no-supervision laws end up passing them, 30 states will be in that group. To me, it's amazing that this is still a state-level issue. If we're talking about changing the face of who can and will be responsible for our comprehensive health and well-being, wouldn't we want that to be the same whether we live in Arizona or Virginia or Michigan? The other inconsistency here is the recognition of the value of nurse practitioners' services, in the form of reimbursement. While healthcare reform policy makes it possible for NP-run practices to get reimbursed at full rates by insurers, the Medicare reimbursement will stay at 85 percent of a physician's rate for the same services. Both the AAFP and AANP have strong feelings on this issue, and it feels more like long-term evolution than it does a sudden change based on healthcare reform.