Let nurse practitioners do more

Via commonwealthmagazine.org

 

 

 

AS A NURSE PRACTITIONER with over 27 years of experience, I understand what it means to provide high quality health care. I have counseled young mothers to track their babies’ milestones, ordered diagnostic tests to confirm the presence of chronic disease, prescribed medications to treat conditions from arrhythmias to pneumonia, identified mental health challenges, and coached hundreds of patients toward prevention and wellness.

 

In practice settings across Massachusetts, the demand for primary care has skyrocketed. As of January 2016, there are 72 so-called health professional shortage areas in Massachusetts and 6,100 across the United States – a number that has grown by nearly 300 communities in just 18 months, according to the Department of Health and Human Service’s Health Resources and Services Administration.

 

There is a way to fix the primary care crisis, and nurse practitioners know the prescription. Nurse practitioners have been at the forefront of providing primary health care to patients for over half a century. With more than six years of academic and clinical preparation, we assess patients, order and interpret diagnostic tests, make diagnoses, and initiate and manage treatment plans – including prescribing medications. We are the health care providers of choice for millions of patients, and manage 990 million patient visits per year.

 

More than 40 percent of states have adopted full practice authority licensure and practice laws, enabling nurse practitioners to deliver care without physician supervision. These states recognize that full practice authority improves access, especially in underserved urban and rural areas, streamlines care, decreases costs, and protects patient choice. In the last five years alone, seven states have enacted full practice laws, and this year states, including Massachusetts, Pennsylvania, and North Carolina, are among those considering such legislation. Organizations including the Institute of Medicine, Bipartisan Policy Center, National Governors Association, Federal Trade Commission, and AARP acknowledge that health care providers working at the top of their education and clinical preparation can improve health care delivery.

 
 

a:link { color: #ffffff }a:visited { color: #ffffff }a:hover { color: #ffffff }a:active { color: #ffffff } –>

(function(){var b=this;var f=String.prototype.trim?function(a){return a.trim()}:function(a){return a.replace(/^[\s\xa0]+|[\s\xa0]+$/g,””)},m=function(a,c){return a<c?-1:a>c?1:0};var n;a:{var p=b.navigator;if(p){var q=p.userAgent;if(q){n=q;break a}}n=””};var r=-1!=n.indexOf(“Opera”)||-1!=n.indexOf(“OPR”),t=-1!=n.indexOf(“Trident”)||-1!=n.indexOf(“MSIE”),u=-1!=n.indexOf(“Edge”),v=-1!=n.indexOf(“Gecko”)&&!(-1!=n.toLowerCase().indexOf(“webkit”)&&-1==n.indexOf(“Edge”))&&!(-1!=n.indexOf(“Trident”)||-1!=n.indexOf(“MSIE”))&&-1==n.indexOf(“Edge”),w=-1!=n.toLowerCase().indexOf(“webkit”)&&-1==n.indexOf(“Edge”),x=function(){var a=b.document;return a?a.documentMode:void 0},y;a:{var z=””,A=function(){var a=n;if(v)return/rv\:([^\);]+)(\)|;)/.exec(a);if(u)return/Edge\/([\d\.]+)/.exec(a);if(t)return/\b(?:MSIE|rv)[: ]([^\);]+)(\)|;)/.exec(a);if(w)return/WebKit\/(\S+)/.exec(a);if(r)return/(?:Version)[ \/]?(\S+)/.exec(a)}();A&&(z=A?A[1]:””);if(t){var B=x();if(null!=B&&B>parseFloat(z)){y=String(B);break a}}y=z}var C=y,D={},E=function(a){if(!D[a]){for(var c=0,d=f(String(C)).split(“.”),e=f(String(a)).split(“.”),k=Math.max(d.length,e.length),l=0;0==c&&l<k;l++){var J=d[l]||””,K=e[l]||””,L=RegExp(“(\\d*)(\\D*)”,”g”),M=RegExp(“(\\d*)(\\D*)”,”g”);do{var g=L.exec(J)||[“”,””,””],h=M.exec(K)||[“”,””,””];if(0==g[0].length&&0==h[0].length)break;c=m(0==g[1].length?0:parseInt(g[1],10),0==h[1].length?0:parseInt(h[1],10))||m(0==g[2].length,0==h[2].length)||m(g[2],h[2])}while(0==c)}D[a]=0<=c}},F=b.document,G=F&&t?x()||(“CSS1Compat”==F.compatMode?parseInt(C,10):5):void 0;var H;if(!(H=!v&&!t)){var I;if(I=t)I=9<=Number(G);H=I}H||v&&E(“1.9.1”);t&&E(“9″);var N={};window.ss=function(a){void 0!==N[a]?N[a]++:N[a]=1;var c=document.getElementById(a),d=N[a];if(window.css)css(a,”nm”,d,void 0,void 0);else if(c){a=c.href;var e=a.indexOf(“&nm=”);if(0>e)d=a+”&nm=”+d;else var e=e+4,k=a.indexOf(“&”,e),d=0<=k?a.substring(0,e)+d+a.substring(k):a.substring(0,e)+d;c.href=2E3<d.length?a:d}};}).call(this);function su(id) {var a = document.getElementById(id);var b = (new Date()).getTime();if (a && a.myt && b) {var t = b – a.myt;if (window.css) {css(id,’clkt’,t);return;}var bi = a.href.indexOf(“&clkt=”);if (bi > 0) {var c = a.href.substring(0, bi+6); var d = a.href.substring(bi+6, a.href.length);var ei = d.indexOf(“&”);var r = ”;if (ei >= 0)r = d.substring(ei, d.length);a.href = c + t + r; } else {a.href += “&clkt=” + t;}}}(function(){var d=this;var g=String.prototype.trim?function(a){return a.trim()}:function(a){return a.replace(/^[\s\xa0]+|[\s\xa0]+$/g,””)},m=function(a,b){return a<b?-1:a>b?1:0};var n;a:{var p=d.navigator;if(p){var q=p.userAgent;if(q){n=q;break a}}n=””};var r=-1!=n.indexOf(“Opera”)||-1!=n.indexOf(“OPR”),t=-1!=n.indexOf(“Trident”)||-1!=n.indexOf(“MSIE”),u=-1!=n.indexOf(“Edge”),v=-1!=n.indexOf(“Gecko”)&&!(-1!=n.toLowerCase().indexOf(“webkit”)&&-1==n.indexOf(“Edge”))&&!(-1!=n.indexOf(“Trident”)||-1!=n.indexOf(“MSIE”))&&-1==n.indexOf(“Edge”),w=-1!=n.toLowerCase().indexOf(“webkit”)&&-1==n.indexOf(“Edge”),x=function(){var a=d.document;return a?a.documentMode:void 0},y;a:{var z=””,A=function(){var a=n;if(v)return/rv\:([^\);]+)(\)|;)/.exec(a);if(u)return/Edge\/([\d\.]+)/.exec(a);if(t)return/\b(?:MSIE|rv)[: ]([^\);]+)(\)|;)/.exec(a);if(w)return/WebKit\/(\S+)/.exec(a);if(r)return/(?:Version)[ \/]?(\S+)/.exec(a)}();A&&(z=A?A[1]:””);if(t){var B=x();if(null!=B&&B>parseFloat(z)){y=String(B);break a}}y=z}var C=y,D={},E=function(a){if(!D[a]){for(var b=0,c=g(String(C)).split(“.”),e=g(String(a)).split(“.”),f=Math.max(c.length,e.length),l=0;0==b&&l<f;l++){var K=c[l]||””,L=e[l]||””,M=RegExp(“(\\d*)(\\D*)”,”g”),N=RegExp(“(\\d*)(\\D*)”,”g”);do{var h=M.exec(K)||[“”,””,””],k=N.exec(L)||[“”,””,””];if(0==h[0].length&&0==k[0].length)break;b=m(0==h[1].length?0:parseInt(h[1],10),0==k[1].length?0:parseInt(k[1],10))||m(0==h[2].length,0==k[2].length)||m(h[2],k[2])}while(0==b)}D[a]=0<=b}},F=d.document,G=F&&t?x()||(“CSS1Compat”==F.compatMode?parseInt(C,10):5):void 0;var H;if(!(H=!v&&!t)){var I;if(I=t)I=9<=Number(G);H=I}H||v&&E(“1.9.1”);t&&E(“9″);var J=function(a,b,c,e){if(window.css)css(b,c,e,void 0,void 0);else if(a){b=a.href;var f=”&”+c+”=”;c=b.indexOf(f);0>c?e=b+f+e:(c+=f.length,f=b.indexOf(“&”,c),e=0<=f?b.substring(0,c)+e+b.substring(f):b.substring(0,c)+e);a.href=2E3<e.length?b:e}};var O=null,P=function(a){O=a};document.addEventListener&&document.addEventListener(“mousedown”,P,!0);window.xy=function(a,b,c){c=c||b;if((a=a||O)&&b&&c){var e=Math.round(a.clientY-c.offsetTop),f=b.id;J(b,f,”nx”,Math.round(a.clientX-c.offsetLeft));J(b,f,”ny”,e)}};}).call(this);(function(){var d=this;var f=String.prototype.trim?function(a){return a.trim()}:function(a){return a.replace(/^[\s\xa0]+|[\s\xa0]+$/g,””)},m=function(a,b){return a<b?-1:a>b?1:0};var n;a:{var p=d.navigator;if(p){var q=p.userAgent;if(q){n=q;break a}}n=””};var r=-1!=n.indexOf(“Opera”)||-1!=n.indexOf(“OPR”),t=-1!=n.indexOf(“Trident”)||-1!=n.indexOf(“MSIE”),u=-1!=n.indexOf(“Edge”),v=-1!=n.indexOf(“Gecko”)&&!(-1!=n.toLowerCase().indexOf(“webkit”)&&-1==n.indexOf(“Edge”))&&!(-1!=n.indexOf(“Trident”)||-1!=n.indexOf(“MSIE”))&&-1==n.indexOf(“Edge”),w=-1!=n.toLowerCase().indexOf(“webkit”)&&-1==n.indexOf(“Edge”),x=function(){var a=d.document;return a?a.documentMode:void 0},y;a:{var z=””,A=function(){var a=n;if(v)return/rv\:([^\);]+)(\)|;)/.exec(a);if(u)return/Edge\/([\d\.]+)/.exec(a);if(t)return/\b(?:MSIE|rv)[: ]([^\);]+)(\)|;)/.exec(a);if(w)return/WebKit\/(\S+)/.exec(a);if(r)return/(?:Version)[ \/]?(\S+)/.exec(a)}();A&&(z=A?A[1]:””);if(t){var B=x();if(null!=B&&B>parseFloat(z)){y=String(B);break a}}y=z}var C=y,D={},E=function(a){if(!D[a]){for(var b=0,c=f(String(C)).split(“.”),e=f(String(a)).split(“.”),k=Math.max(c.length,e.length),l=0;0==b&&l<k;l++){var J=c[l]||””,K=e[l]||””,L=RegExp(“(\\d*)(\\D*)”,”g”),M=RegExp(“(\\d*)(\\D*)”,”g”);do{var g=L.exec(J)||[“”,””,””],h=M.exec(K)||[“”,””,””];if(0==g[0].length&&0==h[0].length)break;b=m(0==g[1].length?0:parseInt(g[1],10),0==h[1].length?0:parseInt(h[1],10))||m(0==g[2].length,0==h[2].length)||m(g[2],h[2])}while(0==b)}D[a]=0<=b}},F=d.document,G=F&&t?x()||(“CSS1Compat”==F.compatMode?parseInt(C,10):5):void 0;var H;if(!(H=!v&&!t)){var I;if(I=t)I=9<=Number(G);H=I}H||v&&E(“1.9.1”);t&&E(“9”);var N=[0,2,1],O=null;document.addEventListener&&document.addEventListener(“mousedown”,function(a){O=a},!0);window.mb=function(a){if(a){var b;if(b=window.event||O){var c;(c=b.which?1<<N[b.which-1]:b.button)&&b.shiftKey&&(c|=8);c&&b.altKey&&(c|=16);c&&b.ctrlKey&&(c|=32);b=c}else b=null;if(b)if(c=b,window.css)css(a.id,”mb”,c,void 0,void 0);else if(a){b=a.href;var e=b.indexOf(“&mb=”);if(0>e)c=b+”&mb=”+c;else{var e=e+4,k=b.indexOf(“&”,e);c=0<=k?b.substring(0,e)+c+b.substring(k):b.substring(0,e)+c}a.href=2E3<c.length?b:c}}};}).call(this);(function(){var b=this;var e=String.prototype.trim?function(a){return a.trim()}:function(a){return a.replace(/^[\s\xa0]+|[\s\xa0]+$/g,””)},l=function(a,c){return a<c?-1:a>c?1:0};var m;a:{var n=b.navigator;if(n){var p=n.userAgent;if(p){m=p;break a}}m=””};var q=-1!=m.indexOf(“Opera”)||-1!=m.indexOf(“OPR”),r=-1!=m.indexOf(“Trident”)||-1!=m.indexOf(“MSIE”),t=-1!=m.indexOf(“Edge”),u=-1!=m.indexOf(“Gecko”)&&!(-1!=m.toLowerCase().indexOf(“webkit”)&&-1==m.indexOf(“Edge”))&&!(-1!=m.indexOf(“Trident”)||-1!=m.indexOf(“MSIE”))&&-1==m.indexOf(“Edge”),v=-1!=m.toLowerCase().indexOf(“webkit”)&&-1==m.indexOf(“Edge”),w=function(){var a=b.document;return a?a.documentMode:void 0},x;a:{var y=””,z=function(){var a=m;if(u)return/rv\:([^\);]+)(\)|;)/.exec(a);if(t)return/Edge\/([\d\.]+)/.exec(a);if(r)return/\b(?:MSIE|rv)[: ]([^\);]+)(\)|;)/.exec(a);if(v)return/WebKit\/(\S+)/.exec(a);if(q)return/(?:Version)[ \/]?(\S+)/.exec(a)}();z&&(y=z?z[1]:””);if(r){var A=w();if(null!=A&&A>parseFloat(y)){x=String(A);break a}}x=y}var B=x,C={},D=function(a){if(!C[a]){for(var c=0,h=e(String(B)).split(“.”),d=e(String(a)).split(“.”),L=Math.max(h.length,d.length),k=0;0==c&&k<L;k++){var M=h[k]||””,N=d[k]||””,O=RegExp(“(\\d*)(\\D*)”,”g”),P=RegExp(“(\\d*)(\\D*)”,”g”);do{var f=O.exec(M)||[“”,””,””],g=P.exec(N)||[“”,””,””];if(0==f[0].length&&0==g[0].length)break;c=l(0==f[1].length?0:parseInt(f[1],10),0==g[1].length?0:parseInt(g[1],10))||l(0==f[2].length,0==g[2].length)||l(f[2],g[2])}while(0==c)}C[a]=0<=c}},E=b.document,F=E&&r?w()||(“CSS1Compat”==E.compatMode?parseInt(B,10):5):void 0;var G;if(!(G=!u&&!r)){var H;if(H=r)H=9<=Number(F);G=H}G||u&&D(“1.9.1”);r&&D(“9”);var I=function(a,c,h){var d=document;d.addEventListener?d.addEventListener(a,c,h||!1):d.attachEvent&&d.attachEvent(“on”+a,c)};var J,K=!1,Q=!1;I(“mousedown”,function(){K=!0});I(“keydown”,function(){Q=!0});document.addEventListener&&I(“click”,function(a){J=a},!0);window.accbk=function(){var a=J?J:window.event;return a?K||Q?!1:(a.preventDefault?a.preventDefault():a.returnValue=!1,!0):!1};}).call(this);function st(id) {var a = document.getElementById(id);if (a) {a.myt = (new Date()).getTime();xy(window.event, a, document.body);mb(a);}}function ha(a,x){ if (accbk()) return;su(a);}function ia(a,e,x) {if (accbk()) return;su(a);}function ja(a,x) {if (accbk()) return;su(a);}function ga(o,e,x) {if (document.getElementById) {var a=o.id.substring(1),p=””,r=””,g=e.target,t,f,h;if (g) {t=g.id;f=g.parentNode;if (f) {p=f.id;h=f.parentNode;if (h)r=h.id;}} else {h=e.srcElement;f=h.parentNode;if (f)p=f.id;t=h.id;}if (t==a||p==a||r==a)return true;ia(a,e,x);top.location.href=document.getElementById(a).href;}}

//–>

</script></head><body leftMargin=”0″ topMargin=”0″ marginwidth=”0″ marginheight=”0″ style=”background:transparent” >

div,ul,li{margin:0;padding:0;}.abgc{height:15px;position:absolute;right:16px;text-rendering:geometricPrecision;top:0;width:15px;z-index:9020;}.abgb{height:15px;width:15px;}.abgc img{display:block;}.abgc svg{display:block;}.abgs{display:none;height:100%;}.abgl{text-decoration:none;}.abgi{fill-opacity:1.0;fill:#00aecd;stroke:none;}.abgbg{fill-opacity:1.0;fill:#cdcccc;stroke:none;}.abgtxt{fill:black;font-family:’Arial’;font-size:100px;overflow:visible;stroke:none;}

var abgp={elp:document.getElementById(‘abgcp’),el:document.getElementById(‘abgc’),ael:document.getElementById(‘abgs’),iel:document.getElementById(‘abgb’),hw:15,sw:96,hh:15,sh:15,himg:’https://tpc.googlesyndication.com’+’/pagead/images/abg/icon.png&#8217;,simg:’https://tpc.googlesyndication.com/pagead/images/abg/en.png&#8217;,alt:’Ads by Google’,t:’Ads by’,tw:34,t2:’Google’,t2w:38,tbo:0,popuptext:”,att:’adsbygoogle’,ff:”,halign:’right’,fe:false,iba:false,lttp:true,umd:false,uic:false,uit:false,ict:document.getElementById(‘cbb’),icd:undefined,uaal:true,opi: false};https://tpc.googlesyndication.com/pagead/js/r20160329/r20110914/abg.js<style>.cbc{background-image: url(‘https://tpc.googlesyndication.com/pagead/images/x_button_blue2.svg&#8217;);background-position: right top;background-repeat: no-repeat;cursor:pointer;height:15px;right:0;top:0;margin:0;overflow:hidden;padding:0;position:absolute;transform: scaleX(1);width:16px;z-index:9010;}.cbc.cbc-hover {background-image: url(‘https://tpc.googlesyndication.com/pagead/images/x_button_dark.svg&#8217;);}.cbc > .cb-x{height: 15px;position:absolute;width: 16px;right:0;top:0;}.cb-x > .cb-x-svg{background-color: lightgray;position:absolute;}.cbc.cbc-hover > .cb-x > .cb-x-svg{background-color: #58585a;}.cb-x > .cb-x-svg > .cb-x-svg-path{fill : #00aecd;}.cbc.cbc-hover > .cb-x > .cb-x-svg > .cb-x-svg-path{fill : white;}.cb-x > .cb-x-svg > .cb-x-svg-s-path{fill : white;}</style>

</div> <style>.ddmc{background:#ccc;color:#000;padding:0;position:absolute;z-index:9020;max-width:100%;box-shadow:2px 2px 3px #aaaaaa;}.ddmc.left{margin-right:0;left:0px;}.ddmc.right{margin-left:0;right:0px;}.ddmc.top{bottom:20px;}.ddmc.bottom{top:20px;}.ddmc .tip{border-left:4px solid transparent;border-right:4px solid transparent;height:0;position:absolute;width:0;font-size:0;line-height:0;}.ddmc.bottom .tip{border-bottom:4px solid #ccc;top:-4px;}.ddmc.top .tip{border-top:4px solid #ccc;bottom:-4px;}.ddmc.right .tip{right:3px;}.ddmc.left .tip{left:3px;}.ddmc .dropdown-content{display:block;}.dropdown-content{display:none;border-collapse:collapse;}.dropdown-item{font:12px Arial,sans-serif;cursor:pointer;padding:3px 7px;vertical-align:middle;}.dropdown-item-hover, a.dropdown-item.dropdown-item-hover {background:#58585a;color:#fff;}.dropdown-content > table{border-collapse:collapse;border-spacing:0;}.dropdown-content > table > tbody > tr > td{padding:0;}a.dropdown-item {color: inherit;cursor: inherit;display: block;text-decoration: inherit;}</style>