For many decades, the focus of healthcare has been on the management of acute illness. Now, health promotion, disease prevention, and chronic disease management has shifted the focus of healthcare to be more patient-centered. Nurse practitioners can treat patients, diagnose ailments, and prescribe medications at a lower cost than doctors (Pickert, 2009). SB 263 would not only impact nurse practitioners, but also physicians, nurses, patients, and the entire health care system.
Doctors in some cases have lobbied to restrict nurse practitioner’s services. “In some situations, it can be a turf battle,” says Rebecca Patton, president of the American Nursing Association (Pickert, 2009). It is suggested that nurse practitioner training is inadequate and that nurses should retrain as doctors (Knight, 2008). Many physicians are against this bill because they fear the potential loss of patients. If nurse practitioners were able to practice independently, their role would move from that of a physician’s inferior, to a competitive member of the health care system. Some physicians feel like they worked harder to achieve medical status and this bill threatens to allow nurse practitioners to practice almost as an equal. On the other hand, a broader definition of the scope of NP practice would enable expansion of primary care services to better serve the healthcare needs of the nation (Sherwood, Brown, Fay, & Wardell 1997). Nurse practitioners have been found to give more advice on self care and management and give better patient satisfaction (Burke, 2009).
From a client perspective, many patients prefer seeing a NP because they feel they receive more patient centered care and preventative medicine. Some research suggests that NPs spend more time per visit with their patients than physicians, although the average number of visits per patient was equivalent (Sherwood, Brown, Fay, & Wardell 1997). Conversely, some patients prefer doctors for their technical skills and would rather see a physician if they think their symptoms are serious.
There is also the financial impact of this policy change to consider. Medicare reimburses nurse practitioners 85% of what is paid to doctors for the same services.
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The fact that patients would be provided with increased access to health care is a good reason in itself to pass Senate Bill 263. Although many doctors and nurse practitioners may enjoy working as a team, nursing practice would be more efficient if regulated by the Board of Nursing. It seems that there would also be less confusion in terms of what a nurse practitioner's scope of practice involves. Even if physicians see the passage of this bill as a threat to the number of patients they see, there are still services that only physicians can provide. If physicians and nurse practitioners had some competition amongst one another, perhaps both would have even more incentive to achieve better patient outcomes.
ReplyDeleteBetter patient outcomes are one of the key reasons why we support this bill. What we want to advocate is that this bill will provide Nurse Practitioners with more autonomy. With independent NPs, MDs would most likely have more time to focus care on patients. Now, the average amount of time a Doctor spends with a patient is only 3-5 minutes on the floor. That amount of time would increase, and allow the quality of care to improve. As a group of nursing students, we know how important quality of care is, and how invaluable the skill set of a nurse is. The whole practice is individualized and it is a separate process than that of a physician. You make a good point in addressing the conflict this bill brings up between MDs and NPs. We want to emphasize how this would not be a threat to MDs but a way advance the care that is given to patients.
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