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Nursing News: Will Thousands of Nurses Set Up Primary Care Practices?

Written by LeAnn Thieman, CSP, June 18th, 2013

Eleven states are considering legislation that would permit nurses with a master’s degree or higher to order and interpret diagnostic tests, prescribe medications and administer treatments without physician oversight. Similar legislation is likely to be introduced soon in three other states.

If the proposals, which face opposition from some physicians’ groups, succeed, the number of states allowing nurses to practice without any type of physician supervision would increase from 16 to 30, in addition to the District.

The legislation being proposed could spur tens of thousands of nurses to set up primary-care practices that would be virtually indistinguishable from those run by doctors. The last big legislative push of this type, a state-by-state effort that began in the late 1980s, sputtered by the early 1990s. This time, however, the campaign is being coordinated nationally by the Nurse Practioners Association and other nursing groups and is getting a critical boost from state officials concerned about the 2010 health-care law’s looming impact on the availability of doctors.

Beginning in January 2014, about 27 million uninsured Americans are expected to get coverage under the law, contributing to a projected shortage of about 45,000 primary-care physicians by 2020, according to the Association of American Medical Colleges.

The nurses have won the support of faith-based organizations, social workers, patients’ groups and the National Governors Association. Perhaps the most valuable endorsement came from experts convened by the National Academy of Sciences’ prestigious Institute of Medicine. The IOM panel, in a report issued in 2010 after the adoption of the health-care law, found no evidence that nurse-run practices were unsafe and concluded that “now is the time” to allow nurses to practice to the full extent of their education and training without limitations by doctors.

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