Can Expanding the Practice of Non-Physician Clinicians Make our Health System Better?

     Increasing the scope of practice of non-doctor clinicians should be done to improve our health care system and reach the Institute of Health Improvement’s (IHI) triple aim of reducing cost, improving patient experience, and patient’s health (Whittington, Nolan, Lewis, & Torres, 2015).  I agree this needs to be done as soon as possible in lieu of the primary care physician shortage and fewer medical students choosing primary care (Pettersen et al., 2012). The nurse practitioners with full scope of practice could fill this void and collaborate with physicians to improve access, quality, and health of patients (Salmon & Echevarria, 2017).

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     Barriers to expanding the roles of nurse practitioners include state laws with a restricted scope of practices, lower insurance reimbursements, American Medical Association (AMA) resistance to a full scope of practice, hospitals denying privileges, and lack of physician knowledge as to what full scope of practice means (Hain & Fleck, 2014).  Viable solutions include encouraging states and AMA skeptics to support full scope of practice in all states by sharing evidenced-based research demonstrating the nurse practitioners’ abilities to treat patients often with better outcomes and patient satisfaction than physician counterparts (Swan, Ferguson, Chang, Larson, & Smaldone, 2015; Mundinger et al., 2000).  Educating physicians about the profession and the collaborative role it could play in assisting to transform healthcare to a preventative care model.  Equate reimbursement for nurse practitioners and physicians when performing an equal task and equate privileges in hospitals. (Salmon & Echevarria, 2017).

     The time for action is now. If states, the AMA, and physicians could change the lens in which they currently see nurse practitioners, they would see the expansion of this role as one of the solutions to making our healthcare system better and assist them in meeting IHI’s triple aim.



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