Restraint of Trade: Organized Medicine is Building Barriers Instead of Bridges

Abstract

With the passage of the Affordable Care Act millions more Americans are seeking healthcare through marketplace insurance that they were able to purchase.   We have seen that there are insufficient family practice physicians to meet this overwhelming need for care, yet organized medicine continues to create barriers to the one group of health care providers that can serve as a bridge to the future: the nurse practitioners (“NPs”).  Many major organizations including the FTC, National Governors, Institute of Medicine, American Association of Nurse Practitioners, American Nurses Association, etc. have advocated on behalf of NPs to reexamine outdated legislation and, where possible, to change that legislation so that it is congruent with the technological, biological, and medical changes that have occurred in our healthcare system over the past 50 years.

Supposed quality and safety issues relating to nurse practitioners have repeatedly been debunked.  Patient outcomes for both NPs and family physicians have been shown to be equivalent; in fact, in some cases, NPs fare better in terms of outcomes than our physician colleagues.  Competency of NPs is initiated and maintained through certification exams, continuing education, and workshops similarly to our physician colleagues.

The quest for NP autonomy is simply a desire to practice according to the education and skills that our respective states’ “scope of practice” regulations allow.  In point of fact, no healthcare provider truly works “independently” because we all rely on one another: NPs refer to specialists, MD’s refer to surgeons and surgeons refer back to internal medicine.  Restraint of one profession by another simply leads to litigation. If we all are to make a difference in terms of the access to and quality of health care, then the path we should follow is clear: it is time to break down the barriers and begin building bridges, for only by working collaboratively will we be providing the best care for our patients.