“An ounce of prevention is worth a pound of cure,” as the saying goes. Yet high-quality preventive care is out of reach for many Americans, leading to late detection of diseases and poor management of chronic conditions.
A recent survey revealed that nearly 40% of Americans have canceled or not scheduled a doctor’s appointment because the wait time was too long.
In response, many states are empowering non-physician health care providers to offer a broader range of services. The latest example is Oklahoma, where the state legislature recently granted nurse practitioners the authority to prescribe routine medications – such as antibiotics and drugs to manage blood pressure – without needing a physician’s signature. Twenty-seven states have already enacted similar reforms.
While Governor Stitt opposed the bill, the legislature overrode his veto by wide margins, reflecting overwhelming support from across the state.
Oklahoma’s law is a big step forward for residents of the Sooner State, especially the 30% of Oklahomans who live in primary care shortage areas with few physicians’ offices and prohibitive wait times for appointments. Permitting nurse practitioners to practice independently removes bureaucratic hassles and unnecessary costs, while allowing physicians to focus on more complex cases.
Nurse practitioners undergo at least six years of rigorous training in routine diagnostics, chronic disease management, preventive care, and patient education. Why not allow them to serve patients to the fullest extent of their skills?
Numerous studies have shown that these reforms deliver significant benefits to patients. Expanding nurse practitioner scope of practice increases access to healthcare services and the frequency of routine check-ups, reduces costs for patients, reduces hospital readmissions and preventable emergency room visits, and improves health outcomes. Moreover, nurse practitioners are more likely to work in rural or underserved communities if their states grants them full practice authority.
While the shortage of primary care physicians is projected to grow even deeper, reaching a nationwide deficit of up to 40,000 doctors in 2036, the supply of nurse practitioners is soaring. Today, there are approximately 100,000 more nurse practitioners in the U.S. than primary care physicians – and the gap is growing every year. Placing artificial limits on the nurse practitioner workforce just doesn’t make sense.
Physician associations have consistently opposed efforts to expand other providers’ practice authority. A common argument is that nurse practitioners may not provide the same quality of care as physicians, resulting in more medical errors and harm to patients.
But decades of data contradict these claims. Across a wide range of quality measures – including opioid prescribing rates, malpractice payouts, and adverse action reports – researchers have found no discernable evidence that expanding nurse practitioners’ practice authority jeopardizes patient safety.
While Oklahoma’s reform represents significant progress, policymakers could do more to maximize its positive impact. For example, the law includes a requirement that nurse practitioners must accrue 6,240 hours (more than three years) of supervised clinical experience under a physician before gaining independent practice authority.
By contrast, most states that grant nurse practitioners independent practice authority do not require any supervision period, and those that do usually have shorter time restrictions. There is no evidence that lengthy supervision periods improve outcomes.
The evidence is clear. Independent-practice nurse practitioners provide high-quality care to millions of patients in the U.S. But too many states continue to restrict their practice authority, depriving patients of accessible care.
Allowing nurse practitioners to do the jobs they were trained to do isn’t radical. It’s just common sense.
Liam Sigaud is a research analyst at the Knee Regulatory Research Center at West Virginia University.