Nurse Practitioners and the Affordable Care Act

The Affordable Care Act promises to insure 32 million more Americans.  Where will these individuals receive their medical care?  Julie Fairman, writing for the New England Journal of Medicine, believes that nurse practitioners are not only the solution to the shortage of primary care providers but that nurse practitioner's scope of practice must be expanded from it's current model.

The concern with expanding nurse practitioner's ability to provide medical care is that it will be of lower quality than that of physicians and therefore not as safe.  Studies indicate, however that chronic disease management and treatment of common, acute illnesses can be provided as safely and effectively by nurse practitioners as physicians.

In some states, nurse practitioners are not allowed to prescribe medications, admit patients to the hospital or certify home health visits without physician oversight.  In only sixteen states are nurse practitioners allowed to practice independently and prescribe medication without physician oversight.  Given the impending shortage of primary care providers, this must change.  All states must allow nurse practitioners to practice and prescribe independently.

Broadening nurse practitioner's scope of practice will bring primary care services to individuals who would not have otherwise had access to medical care.  It will save states money ($4.2 to $8.4 billion over 10 years according to one Massachusetts study).  The growing shortage of primary care providers necessitates a change in how primary care services are delivered.  Part of this change must be the independent practice of nurse practitioners.