When your young child is under the weather or your infirm parent is uncomfortable, a delay in health care is a denial of care. And the feeling of helplessness as a parent or caretaker is excruciating.
This scenario is familiar to far too many Kansans, especially those in rural communities.
We can’t recruit our way out of this problem or launch a charm offensive to encourage enough aspiring physicians to settle in our great state once they have their M.D. Kansas is not alone. Nationwide, demand for primary care services is growing, while the number of primary care physicians is not, leading to a projected shortage of more than 20,000 providers next year.
But the situation doesn’t have to be so dire — and we don’t have to just accept it. If Kansas lawmakers eliminate the need for superficial collaborative agreements that restrict practice locations for Advanced Practice Registered Nurses, patients throughout our state will have easier, more prompt access to care.
Unfortunately, previous efforts to allow APRNs to provide the care they’ve been trained to perform have failed.
Opponents of these measures cite health and public safety as primary concerns. But 22 states and the District of Columbia already have expanded the scope of practice for APRNs or eliminated the need for collaborative agreements, allowing them to independently treat patients and prescribe medication, and their citizens are better off for it.
An analysis of 26 peer-reviewed studies showed health outcomes to be virtually identical between physician-treated patients and APRN-treated patients. What’s more, when it comes to primary care, The New England Journal of Medicine reports that, “Nurses are more likely to talk with patients and adapt medical regimens to a patient’s preferences, family situation, and environment. They are also more likely to provide disease-prevention counseling, health education, and health-promotion activities, as well as to know about and use community resources, such as nutrition programs, self-help or group therapy, and parenting and stress-reduction programs.”
APRNs are also more likely to spend more time with patients, as doctors are increasingly stuck handling more paperwork. Multiple studies found that doctors often have more face time with their electronic health records systems than they do with actual patients.
Allowing for a greater number of providers also brings down medical costs, which is certainly a plus. A study by Morris Kleiner of the University of Minnesota, a leading expert on occupational licensing, found that well-child visits cost up to 16% more in states with more stringent regulations compared to those that allow nurse practitioners to prescribe medication. He also found that expanding the scope of practice for nurse practitioners decreased physicians’ wages by around 3%.
And therein lies the rub. Many groups who have opposed the expansion of scope of practice for APRNs are composed of those looking out for their bottom line.
Kansas’ doctor shortage is a complex and multi-faceted problem — and in public policy, it is rare to find positive, common sense solutions to such problems. Kansas lawmakers should jump at the next chance to make health care more affordable and accessible throughout our state by allowing APRNs to practice the health care they are trained to give, without superficial regulations in place.