By Justin Leventhal, American Consumer Institute
Many rural and low-income areas face shortages of doctors. These shortages are only projected to get worse and spread to more parts of the country, resulting in a shortage of more than 87 thousand primary care physicians across the U.S. by 2037. State policymakers need to start getting serious to address the current and looming shortage of physicians and change the laws currently preventing nurse practitioners (NPs) from filling these roles to help address the growing gap in primary care providers.
Currently, 23 states still restrict NPs from independently providing primary care needs. These restrictions—better known as “scope of practice" (SOP) laws—are set in every state for NPs and other healthcare personnel to determine what services they can provide independently, what services they require physician oversight, and what they are restricted from doing all together.
Certain tasks will always remain in the realm of physicians. Surgery and specialties require years of specific training that only a relatively small group of physicians have completed. But primary care is not one of those specialties, and NPs have already shown their ability to handle it just as well in 27 states and Washington D.C. With doctor shortages looming, the remaining 23 states should take a lesson before the problem gets worse.
The American Medical Association (AMA) argues that restricting NPs’ SOP is necessary toprevent low-quality healthcare from threatening patient safety. Unfortunately for this argument, the data shows otherwise—as the American Association of Nurse Practitionersrightly pointed out in an open letter to the AMA. When implemented, full practice authority for NPs has come with the same quality of care. Not to mention it reduces the cost of care—physicians cost 34 percent more than NPs when providing primary care.
Expanding the SOP for NPs also has the additional benefit of increasing the number of nurses, further enhancing access to primary care. States with full practice authority for NPs have 22.4 more per 100,000 residents. Giving NPs full practice authority draws more people into an industry where they are desperately needed.
Rural communities have been hit particularly hard by the shortage. Twenty percent of Americans live in rural areas, but only nine percent of doctors do. Full practice authority can help by drawing more NPs into these areas.
But as Congress continues to limit the number of new doctors each year, patients can’t expect a surge of physicians to meet the demand. Increasing access to lower-cost and equally effective primary care options means empowering NPs to compete in the market. The healthcare system doesn’t exist to protect doctors from competition. It exists to care for patients.
Overly burdensome SOPs entrench and enrich a small and shrinking number of doctors at the expense of patients. States without full practice authority for NPs should adopt expanded SOPs and provide patients with more options for primary care. The goal should be bringing low-cost and high-quality care to patients, not protecting a dwindling number of primary care physicians.
Justin Leventhal is a senior policy analyst for the American Consumer Institute, a nonprofit education and research organization that advocates for consumers through evidence-based analysis and data. Visit www.TheAmericanConsumer.Org or follow on X @ConsumerPal.
