health care

When Nurse Practitioners Step in for Doctors

The case for deregulation.


JoNel Aleccia has a good piece at the NBC News website about nurse practitioners providing medical care where there are few or no licensed doctors:

Pre-Code, but not pre-cartel.

Experts estimate the U.S. is already short more than 9,000 primary care physicians, a number expected to rise to 65,800 by 2025, according to the Association of American Medical Colleges….

"To me, nurse practitioners could be a huge, huge solution to this problem of primary care shortage," said Dr. Thomas Bodenheimer, a professor of family and community medicine at the University of California, San Francisco, School of Medicine.

NPs, as they're sometimes known, are registered nurses who hold graduate degrees and can perform virtually all of the functions of front-line family doctors—depending on the laws of the state they're in.

"They can do 90 to 95 percent of what the docs can do," said Bodenheimer, a medical doctor who practiced primary care himself for three decades.

More patients are recognizing that: Between 1998 and 2010, the number of Medicare patients treated by NPs increased 15-fold to more than 450,000 people, University of Texas Medical Branch researchers found recently.

But advocates say that many of the nation's 106,000 nurse practitioners, including about 56,000 who practice primary care, are hamstrung by state laws that limit their authority.

Aleccia notes that there are at least 18 states where these nurses are permitted to "practice independently, without the supervision of physicians." But the doctors' monopoly is strong elsewhere in the U.S., where "so-called 'scope of practice' laws limit NPs' ability to diagnose, treat and prescribe medications without physician supervision."

Read the rest of the piece here. For more on the case for loosening medical licensing laws, go here.