Con­trol is­sues

Modern Healthcare - - Opinions Letters -

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

New York

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