Effort to expand health care access

There is an abundance of misinformation circulating by physician organizations to legislators and citizens of Oklahoma regarding Senate Bill 839. The biggest misconception is that it would change the scope of practice for advanced practice registered nurses (APRNs) in Oklahoma.

The scope of services provided to patients would not change with the passage of SB 839; it simply would remove a regulatory barrier requiring a collaborating physician's signature on the APRN license, allowing them to write prescriptions. Oklahoma APRNs have been doing this safely and effectively for decades, but at a huge financial cost. Many collaborating MDs/DOs are charging APRNs up to $5,000 per month to sign the APRN license application. Is it any wonder the physician associations vehemently oppose this change?

Oklahoma and other rural states have a shortage of primary care providers, effectively limiting access to essential primary care, resulting in poor health outcomes. APRNs are uniquely poised to help change Oklahoma's abysmal statistics.

Nurse practitioners account for one in four medical care providers in U.S. rural practices — a significant 43.2 percent increase from 2008 to 2016, according to research published in the June 2018 issue of the journal Health Affairs. This increase in rural providers is a direct result of lifting barriers that prohibit the patients' access to providers. Without abolishment of Oklahoma's requirement for a collaborating physician agreement, Medicaid recipients and rural Oklahomans will continue to have limited access to essential primary care services.

Twenty-three states have granted APRNs the ability to practice without any physician oversight, without problems related to patient safety. Studies find that APRNs who provide preventive care are as effective as primarycare physicians in accuracy of diagnosis and prescription. Regarding indicators such as controlling patient blood pressure and glucose levels and reducing hospital readmissions, APRNs often score higher than physicians. According to a 2013 health policy brief in Health Affairs, “A systematic review of 26 studies published since 2000 found that (patient) health status, treatment practices, and prescribing behavior were consistent between NPs and physicians.”

The National Academy of Medicine, National Governors Association, AARP and other organizations support APRNs' ability to function at the level of their education and training. It's time for Oklahoma to allow APRNs to practice without physician collaborative agreements. In doing so, we will join other states that have improved the cost and quality of health care in their communities by increasing access to local, affordable options for medical treatment.

Schaeffer, of Oklahoma City, is an advanced practice registered nurse.