When physicians respond negatively to the Institute of Medicine’s recommendation to lift any restrictions on nurse practitioners practicing to their maximum possible level, it clearly indicates a control issue (“RWJF joins push to widen nurses’ roles,” ModernHealthcare.com, Nov. 29). And when medical doctors can control all of the nursing profession, it prevents progress and keeps the public from accessing care they need. There is no valid argument that allowing nurse practitioners more autonomy could jeopardize quality of care as the American Medical Association has said. All we need is to show the data that refutes this, which is data that led to the IOM’s report.
Many states have laws allowing nurse practitioners to work with greater autonomy. In states where physician supervision is legally required, it serves only to lessen access to NPs while not reducing the tendency for NPs to collaborate with MDs when they need to anyway. Just as an MD in primary care may refer a patient to a pulmonologist or a dermatologist for issues beyond their scope of practice, so do nurse practitioners collaborate with primary-care and specialty MDs to get patients care beyond what they can provide. What is at issue here is that NPs are qualified to provide primary care, and there is no reason any state should bar the public from accessing an NP for primary care. It is in the medical code of conduct to work toward the public health, and collaborating with NPs is good for all, without restrictive practice laws. Jennifer Merritt-Hackel Columbia University