During the first week of October, America celebrates National Primary Care Week, honoring the difficult work that family physicians, pediatricians, and other primary care doctors do every day to provide routine medical care. But, unfortunately for us, there aren't enough of them to care for our country's growing medical needs. Over 84 million Americans, one-quarter of the U.S population, live in counties with a severe primary care physician shortage, according to data from the Department of Health and Human Services (HHS). From Colusa County in California to East Delaware County in New York, patients are suffering from this debilitating doctor shortage.
There is a way to bridge this gap: allowing the qualified professionals known as nurse practitioners (NPs) to perform these important services. Much like doctors, NPs are trained to provide a variety of primary care procedures including diagnosing illnesses, treating conditions, and prescribing medications. Yet despite America's growing need for more primary care providers, states around the country have laws that prevent NPs from treating their patients. In 28 states, lawmakers subject NPs to outdated regulations that prohibit them from providing services they are fully certified to offer, like annual exams and pap smears. In other instances, states will mandate that nurses practice under the supervision of a physician, which limits their capacity to serve remote communities.
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Meanwhile, America's doctor shortage is worsening. While America's aging baby boomer generation is entering retirement and demanding more health care services, many doctors are retiring and hanging up their lab coats. Researchers at the Association of American Medical Colleges estimate that by 2030 there will be 49,000 fewer primary physicians than the country will need to serve our growing health care needs. Ultimately, patients seeking basic primary care will have to travel farther, wait longer, and pay more.
Supporters of NP restrictions claim that allowing nurses to perform primary care would endanger patient health. However, these claims are baseless—nurses can perform nearly all the services of a primary care doctor at the same high standards we expect from physicians. A 2013 review of 26 peer-reviewed studies in the journal Health Affairs found that patients treated by NPs enjoy the same health outcomes as those served by physicians.
The reality is that relaxing state restrictions on NPs would dramatically expand access to high-quality primary care. Since NPs need five fewer years of training to practice than physicians, nurses can more swiftly deploy to under-served areas. And surveys conducted by the American Academy of Nursing found that nurses are far more likely than doctors to operate in rural communities and in nontraditional settings—like urgent care and in-store clinics—allowing them to reach patients who lack reliable access to a physician.
Patients save money on healthcare by going to an NP, too. Because nursing degrees cost substantially less than a physician's medical degree, NPs charge significantly less than doctors, passing along their savings to patients. According to research by economist Morris Kleiner of the Brookings Institute, preventive care for children costs 16 percent less in states that actually allow nurses to freely practice the medicine they're trained in.
The federal government is all too aware of the negative implications caused by the restrictions on NPs.
The federal government is all too aware of the negative implications caused by the restrictions on NPs. In fact, it has recommended that states remove such laws. In 2013, President Obama's HHS estimated that states could reduce America's primary care shortage by two-thirds—simply by loosening laws that prevent NPs from treating their patients independently. And earlier this year, HHS Secretary Alex Azar urged lawmakers attending the American Legislative Exchange Council conference in New Orleans to end their "barrier[s] to new competition and lower-cost [NPs]."
Medical experts and policymakers across the political spectrum recognize that NPs can make a big difference in the lives of millions of Americans who are struggling to attain primary care. Allowing these qualified nurses to independently serve patients is a bipartisan solution that states should adopt—finally granting enough medical care access to those who need it most.
