Mississippi frequently makes news headlines about health care and unfortunately, many of these headlines are negative.
However, this year our legislators have an opportunity to take a very positive step in making good news in health care — and more importantly, bringing a tangible impact on improving access to quality health care for thousands of Mississippians.
The Mississippi Business Journal recently reported that the “shortage of physicians is an issue across the United States, but it is particularly acute in Mississippi, which ranks 50th in the country in access to active physicians per capita.”
This physician shortage combined with 57% of Mississippians living in rural parts of our state presents major obstacles when it comes to the availability of quality health care. Lack of access worsens patient outcomes and ultimately increases the health care cost burden for our state budget.
One of the solutions to this challenge is to allow advanced practice registered nurses, commonly called APRNs, to practice to the full extent of their education and training. Currently, APRNs are not allowed to provide care for patients unless they enter into an agreement with a licensed physician, creating access to care issues across our rural and underserved areas without improving patient safety or outcomes. Removing unnecessary restrictions on APRNs would greatly increase access to quality, safe health care.
APRNs are not aiming to replace medical doctors, nor will their scope of practice expand. APRNs will continue to refer to specialist physicians when appropriate. Instead, APRNs are hoping lawmakers in Mississippi will follow the leadership of over half of the states in allowing APRNs to fully utilize their specialized education and training. The four APRN roles—Clinical Nurse Specialists, Certified Nurse Practitioners, Certified Nurse-Midwives, and Certified Registered Nurse Anesthetists—provide expert care in areas including primary care, anesthesia, maternal/fetal health, and mental health.
Patient safety should always be at the forefront of any change to health care policy. There are several factors that demonstrate that the current status quo in Mississippi does not protect patients, and that removing barriers on APRNs will increase access to safe and quality care.
First, under the current law that requires physician collaboration agreements, many physicians do not have regular contact with the APRNs they are overseeing. Contrary to the “collaboration” terminology, this is not a side-by-side working relationship. In addition to restricting their trade, APRNs are often required to pay fees to physicians which can be very costly for small businesses.
Second, over 300 studies demonstrate that APRNs provide safe, competent, quality health care. These studies find no difference in patient outcomes for patients treated by physicians compared to those treated by APRNs. These studies looked at both states with restrictions like Mississippi, and those states that have removed barriers.
The Federal Trade Commission’s 2014 report on this issue, titled “Competition and the Regulation of Advanced Practice Nurses,” stated the following: “Based on substantial evidence and experience, expert bodies have concluded that APRNs are safe and effective as independent providers of many health care services within the scope of their training, licensure, certification and current practice.”
And third, more than half of states have already removed restrictions on APRNs, allowing APRNs to practice without mandated agreements with physicians, resulting in increased access to quality health care for the residents of these states. For example, Arizona saw a significant increase of nurse practitioners after they removed restrictions in 2001 and of those, 70% were nurse practitioners locating in rural areas of the state.
It’s past time for Mississippi to join the growing number of states in addressing the problem of health care access. We can start by allowing highly qualified APRNs to do the jobs they are trained to do.
Mississippi must take steps now to address access to primary care for our citizens. Legislators have a great opportunity to make a change that will have a quick, long-lasting, and positive impact on the health of our citizens.
Please let your legislators know you support Senate Bill 2628 and House Bill 613. You can also go online to https://nursingmississippi.com to find our more information about this issue.
By encouraging your state representatives and state senators to support legislation allowing APRNs to practice without unnecessary barriers, you can make a real difference to improve health care access in our state.
Adam P. Clay is a family nurse practitioner from Oxford, Mississippi.