NCPA - National Center for Policy Analysis

California Mulls Expanding Role for Nurse Practitioners

May 16, 2013

As the Affordable Care Act increases the number of Americans seeking treatment in the health care system, there will be a shortage of doctors. California, like 15 other states, is considering whether to allow advanced practice nurses more autonomy and authority. The potential move could address some of the shortage of doctors in the future, says Kaiser Health News.

  • Nurse practitioners are advanced practice registered nurses who have complete additional training beyond that of a registered nurse.
  • In low-income sections of major cities, like San Francisco's Tenderloin district, nurse practitioners are already providing health care to individuals with reduced access to the health services they need.
  • In San Francisco, Glide Health Services, which provides coverage to the Tenderloin district, is run primarily by nurse practitioners, with a physician visiting 12 hours a week to sign forms and consult on difficult cases.

Much of the workload on physicians is for fairly common illnesses with standard treatments that nurse practitioners have had the training to diagnose and treat. The low-income individuals who visit Glide Services have been happy with the health care receive, noting that the nurse practitioners are friendly and compassionate.

  • Current California laws require that nurses treat a patient only after consulting a doctor.
  • Some lawmakers are attempting to eliminate this requirement, a move that many physicians oppose because they say that nurse practitioners are only one part of the medical team necessary to provide care.
  • According the California Medical Association, nurse practitioners do not have as much training or know enough about testing and technology as doctors do.

Physicians also note that the proposed legislation does not stipulate that nurse practitioners practice in underserved or underprivileged areas. The question is whether or not nurse practitioners have enough training to provide basic primary care.

  • A California health economist notes that nurse practitioners are actually more likely to practice where there are more Medicaid patients or in rural communities.
  • The California bill to allow nurse practitioners to offer treatment without consulting a doctor will go before the Senate appropriates committee next week.

Source: Pauline Bartolone, "California Weighs Expanded Role for Nurse Practitioners," Kaiser Health News, May 9, 2013.


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