Deficiency in the number of health care professionals in the U.S. is reaching alarming numbers. The promising fact is that the growing number of nurse practitioners can potentially address the mentioned deficiency. Nurse practitioners are well-equipped to meet the growing demand for health care professionals, especially in underserved locations. However, many barriers, such as restrictive scope of practice policies and unequal reimbursements, impede their abilities to do so.

Unfortunately, only about one-third of the states in the U.S. have granted nurse practitioners full practice authority. The remainder have either restricted their practice domain or imposed licensure regulations on them. In the states where nurse practitioners’ practice is restricted, they are required to work under a physician’s supervision in order to provide patient care. This creates a barrier to the provision of efficient, cost-effective health care and is contrary to the fact that nurse practitioners have the education, knowledge and skills necessary to independently provide comprehensive health care services.

For instance, in some states nurse practitioners are required to practice within a specified distance of their collaborating physician. This regulation further restricts the use of nurse practitioners in areas that experience physician shortage, which limits nurse practitioners’ ability to practice in underserved areas. Another restriction is imposed in a few states like Kentucky, where nurse practitioners are only allowed to prescribe limited quantities or specific types of medication. Therefore, medical groups may struggle to ensure timely patient access to needed medications.

Removal of the aforementioned barriers would enhance access to health care for the public nationwide. As long as regulatory requirements differ from one state to the other, each state border represents an obstacle to clinicians’ portability and hinders patients’ access to care professionals. Over time, nurse practitioners have demonstrated their ability to provide high-quality and cost-effective care; they need to be given the opportunity to practice autonomously.

Mehrnaz Ghorashi

Portland