State limits on non-physician health care workers block access for patients in need | Expert Opinion
Nurses are not alone in seeing restrictive scope of practice regulations suspended during the pandemic.
Coronavirus has once again proved that health care workers are there for us when we need them and deserve our respect and admiration. A recent Washington Post article states that at least 450,000 health care workers have been infected by COVID-19 worldwide. Sadly, hundreds have died.
As the strain on the United States health care system mounted, policymakers responded by loosening restrictions on practicing across states and taking other actions to extend the reach of non-physician providers, like nurse practitioners, physician assistants and pharmacists. Politicians and policymakers are right to praise the heroic actions of our frontline health care workforce, but we need to make sure that support continues when the crisis ends.
The truth is that there was a provider shortage and access gap before the pandemic, and there will be going forward. Last April, the Association of American Medical Colleges stated the U.S. needs nearly 122,000 additional physicians by 2032 just to keep up with the increasing demands of an aging population. Although nearly two million Americans have been diagnosed with COVID-19, over 62 million lack access to basic primary care, according to Medical Economics.
This inability to access services leads to unnecessary and costly hospitalizations while contributing to preventable health care complications. America’s rate of preventable hospitalizations is 50% higher than the average rate in other developed countries. The U.S. also has the highest rate of premature death for patients with diabetes, hypertension, and certain types of cancer, all of which are considered preventable if patients receive adequate primary care.
One way to lessen the shortage is to remove outdated scope of practice regulations that prevent non-physician providers from caring for patients in need. For example, 29 states require advanced practice nurses to enter into a collaborative agreement with a physician or comply with other supervision requirements before prescribing medications. These agreements can cost thousands of dollars a month and often prevent nurse practitioners from practicing in communities where physicians are scarce. Advanced practice nurses are fully capable of practicing independently and do so in the remaining states. Several governors coping with COVID-19 quickly saw collaborative agreements as a barrier to getting nurses on the frontlines. A number of states have either waived or suspended the requirement during the pandemic.
Nurses are not alone in seeing restrictive scope of practice regulations suspended during the pandemic. Several federal and state emergency response plans also modified rules governing physician assistants, pharmacists, and other providers while lifting prohibitions on interstate practice. These changes made it easier to use telehealth, expanded the workforce, and allowed providers to respond to hard-hit areas.
As the crisis ebbs, we cannot return to business as usual. Let us learn from this experience by using these reforms to ensure every individual has access to all the medical care they need. Our healthcare workers are heroes, and with the proper support, they will meet the challenge of extending access to everyone.
Tine Hansen-Turton is President and CEO of Woods and a member of the Inquirer’s Health Advisory Board Panel. Brian Valdez is a lawyer an advocate who represents the group People for Liberty, Access, Choice & Equality.