Posted: November 26, 2010

Dear Editor,

The Oct. 22 Inside Business article, "When the doctor is...a nurse," discussed the "debate between nurse practitioners and physician-led state groups." As our nation prepares for the influx of new patients created by health care reform, the decline in physicians is predicted to create a gap that nurse practitioners are prepared and qualified to fill.

A Sept. 30 press release from the Association of American Medical Colleges suggests that by 2015 when health reform is fully operational, the U.S. will have a total baseline deficit of 63,000 doctors. Of that estimate, 33,100 will be in specialties such as cardiology, oncology and emergency medicine. The need for health care providers in the primary care setting will be great.

Much progress has been made in the move toward a solution. SB263, the Access to Care Bill introduced during last year's General Assembly session, lobbied to change Virginia's current law, which has not been updated since 1973 and does not reflect the current collegial relationship between nurse practitioners and physicians. Virginia is one of only 12 states that still require physician supervision of nurse practitioners, a requirement that limits access to care in all patient settings.

Nurse practitioners want to use their education, training and board certification to work alongside their physician colleagues to offer skilled, quality health care to all patients, treating when they're able and referring to specialists when necessary. In states without physician supervision, there is no data to suggest a decline in quality of health care, and in fact, studies have shown nurse practitioners can add substantially to physician productivity while proper utilization of nurse practitioners can result in better quality and more coordinated care.

The nonpartisan Macy Foundation, a New York-based charity focused on educating health professionals, recently called for nurse practitioners to be among the leaders of primary care teams and urged the removal of state and federal barriers that prevent nurse practitioners from providing primary care. In October, an Institute of Medicine report stated nurses should be full partners with physicians and other health professionals in redesigning health care in the U.S., and in Virginia, nurse practitioners are actively participating in the Governor's Health Reform Initiative task forces where they hope to work with the Medical Society of Virginia to reach a consensus on legislative change that will increase access to care by ensuring access to nurse practitioners.

According to the American Academy of Nurse Practitioners, there are more than 6 million visits to nurse practitioners each year. These patients report satisfaction with their care, and studies show they have fewer emergency room visits, fewer hospital admissions and shorter hospital stays.

Removing supervision barriers will allow nurse practitioners to be part of the solution in improving access to care for all Americans.

Tammy Maloney, RN, MSN, FNP

Tidewater Region Conference

Committee Chair and Past Presi-

dent Virginia Council of Nurse

Practitioners