Learn About the Nationwide Primary Care Shortage and What It Means for Nurses
Nurse practitioners in the state of Oklahoma took to the state capital on Tuesday, February 12th to talk with lawmakers about the state’s primary care shortage. This day marks the third annual Association of Oklahoma Nurse Practitioners Day, so nurses used the occasion to lobby for greater access to primary care. Oklahoma is one of many states across the country that’s grappling with a primary care shortage, but with a change to the state’s laws, nurse practitioners (NPs) would have more freedom to care for patients, expanding access to primary care across the state. According to the Oklahoma Health Department, 76 of the state’s 77 counties have declared a primary care shortage, leaving patients with few options when it comes to receiving routine care. Learn more about the nationwide primary care shortage and what Oklahoma nurses are doing about it;
Increasing Access to Primary Care in Oklahoma
Oklahoma nurses discussed changes to a state law that would give NPs more freedom to care for patients in the absence of a primary care provider. If passed into law, an amended version of Senate Bill 839 would give nurses with seven or more years of experience the authority to prescribe medications to their patients without requiring a collaborative agreement with a physician. This would allow qualified NPs to provide comprehensive care to their patients without having to coordinate with local physicians, which tend to be in short supply across the state.
NPs lobbying lawmakers argue that 22 other states have similar laws on the books that grant experienced NPs prescriptive authority. Currently, experienced NPs have full prescriptive authority in states like Maine, New Hampshire, Arizona, Oregon, Washington, Minnesota and Iowa, allowing them to prescribe, diagnose, and treat patients without physician oversight. NPs and physician assistants (PAs) can prescribe medications in all 50 states, but many states require physician approval.
While NPs and PAs across the state support the legislation, the Oklahoma State Medical Association opposes it. Across the country, physicians often oppose granting NPs the freedom to prescribe medications to patients without their consent, citing the difference in educational requirements for NPs and physicians. Simply put, physicians often argue they have more knowledge and experience with prescribing medications than NPs, but with a growing nationwide primary care shortage, experienced nurses with the right training can help expand access to care across the country.
Tracking the Primary Care Shortage Nationwide
A new report from the Association of American Medical Colleges estimates that the U.S. could see a physician shortage of up to 120,000 by the year 2030. This is due to a systemic lack of primary care physicians across the country as well as the nation’s growing population, particularly those over the age of 65. Patients living in rural areas often have fewer option when it comes to primary care. Lack of insurance, rising healthcare costs, and traveling long distances is putting a damper on demand for physicians across the country. Med school students also tend to gravitate towards higher-paying jobs in the healthcare industry such as surgeons and other specialties. With mounting student debt, working as a primary care physician isn’t as appealing as it used to be.
At the same time, the number of NPs and PAs in the country has skyrocketed. The NP workforce has increased by 75% from 2000 to 2011 and the number of PAs has increased by over 100% from 2000 to 2010. The makeup of the U.S. healthcare workforce is changing quickly, and many would argue that the country’s laws need to change as well.
What This Means for Nurses Going Forward
Currently, 95% of NPs across the country prescribe medications to their patients and those working in a full-time practice write an average of 23 prescriptions a day. But many of these NPs must get physician approval before prescribing the drug. In areas most affected by the primary care shortage, finding and coordinating with a physician can be difficult, dramatically slowing down the treatment process. Many of these physicians are already overworked and asking them to approve dozens or even hundreds of additional prescriptions can be a challenge.
Nurses should familiarize themselves with the prescriptive laws in their state. Many states have recently introduced legislation that would expand prescriptive authority to NPs and PAs, but many of these bills have been met with opposition. If nurses want to increase their prescriptive authority, they can join one of the many grassroots campaigns across the country that are focused on this issue. Any changes to prescriptive laws will likely take place at the state level, so lobbying state lawmakers and raising awareness for this issue are often the best forms of advocacy.