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Description
The United States is currently facing a physician shortage. On average, 22% of state populations are living in primary care health professional shortage areas. There are over 158,000 nurse practitioners that can meet the demand for health care providers. They are educated in diagnosing and managing common acute and chronic diseases across the lifespan, ordering diagnostic tests, prescribing medications, and performing minor procedures. Most practice in primary care. A review of the literature supports that nurse practitioners deliver safe, cost-effective primary care and should be used. Nurse practitioners could help fill gap between the supply and demand for primary care providers. The scope of practice for nurse practitioners is determined by state law. Even though education requirements are similar across all states, laws for nurse practitioners range from permitting independent practice to requiring physician supervision. This is problematic because in many states nurse practitioners are not allowed to practice to the full extent of their education and training. This paper examines the variation in state laws for nurse practitioners from all 50 states and the District of Columbia. State laws as of January 2012 were accessed from Board of Nursing websites. A ranking criteria was developed to score the restrictiveness of each state's law based on the following characteristics: regulation of nurse practitioners, practice authority and prescriptive authority. States were categorized as being unrestrictive, minimally restrictive, moderately restrictive, or highly restrictive. Nine states had unrestrictive laws for nurse practitioners, twenty-three states had minimally restrictive laws, and sixteen states had moderately restrictive laws, while only three states had highly restrictive laws. The association between the restrictiveness of state nurse practitioner laws and several state characteristics were also examined. State characteristics were obtained from secondary sources and included: state population, region of the United States, number of nurse practitioners per 100,000 people in each state, percentage of the state population living in a primary care health professional shortage area, and male to female earnings ratio. Only state population and region were significantly correlated to the degree of restrictiveness of state laws. Western states and states with smaller populations had less restrictive laws. State policymakers can use the results of this study to see how their laws compare to other states and identify the specific features of their laws that can be amended to promote the independent practice of nurse practitioners. Changing restrictive laws will help reduce access to care barriers for the underserved and potentially lower health care costs. With the vi increasing demand for health care providers, it is imperative that nurse practitioners be allowed to practice to their full scope of their education and training.
