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DNP Answers

Health Policy or Politics?

Published June 25, 2014 3:34 PM by Keischa Cash
The most recent 2014 legislative session was one of excitement and of woes. We saw states like Connecticut, New York and Minnesota get full practice authority legislation signed into law. With the exception of Nebraska's law that was passed unanimously then vetoed by the governor, the 2014 session saw a lot of progress made toward achieving more autonomy for our nation's NPs. I for one was happy to see that Florida (where I reside) actually introduced a bill that included language to grant full practice authority after 2-3 years of being supervised by a physician or NP. This bill came about after the healthcare workforce and innovation sub-committee of the house was designated the task of examining the impact that nurse practitioners, among other professionals, could have on care delivery models in the Sunshine State. Unfortunately, neither HB 7113 nor SB 1352 came to fruition.

After listening tirelessly to hours of testimony by experts on both sides, it seemed undeniable that the solution to the problem of lack of access to quality, affordable care for the citizens of Florida was utilizing the talents of the state's NPs. But yet, despite the overwhelming evidence presented on PowerPoint after PowerPoint and hours of questioning of the panel by legislators, there was still opposition to the idea of allowing NPs in Florida to prescribe controlled substances and having full practice authority. I don't get it! Why have an entire committee dedicated to finding solutions when no one is listening to the facts?

Fact: NPs deliver care equal to or better than that of a physician.
Fact: NPs give safe care.
Fact: NPs are unfairly burdened by laws that prevent them from practicing to their full scope of licensure.

So why, when presented with irrefutable evidence of the quality and safety of NP care documented over the last 60 years, is there still debate? I can only come to one conclusion: some legislators are just motivated by doing what's best for their personal and social affiliations and less about what is for the greater good. Clearly, there is more than meets the eye when it comes to the situation here in Florida between NPs and the medical community at large, and they will go to great lengths to thwart the NP movement here.  

I am appalled at some of the comments made by legislators regarding their views on NPs level of education as inferior to physicians and their apparent lack of knowledge of our educational and experiential requirements for practice was evident. Hopefully, this is where the DNP fits in as we move toward advocacy for doctoral education and preparation of our NP colleagues to create some sort of parity with other health professions and end all of this inter-professional discontent which detracts from our purpose (safe, quality, affordable health care). It seems that despite a society that enjoys facts and truth telling in elections, we lose sight of this importance when it comes to things that hit closer to home. I feel that I have been sent to an alternate universe where decades of evidence and recommendations from the highest medical institute in the country is simply just not good enough for Florida legislators to get a hint. I don't get it. Maybe next year.

Hopeful.                                                               

Dr. Ca$h

4 comments

I agree that it seems that the answer to the provider "shortage" is right there in front of them but they refuse to see it. If the Affordable Care Act (ACA) is successful in obtaining its original goals, there will be 30 million newly insured patients with no plan as to how those patients will access care.

I have recently accepted a teaching position in a Florida NP program and I had hoped to continue to see patients on a per diem basis. I have practiced orthopedics for 32 years in Maryland (19 as an NP) where I have great autonomy. I'm sorry to hear that Florida continues to lag behind.

Walton Reddish, DNP July 4, 2014 5:51 AM
Salisbury MD

Thanks for all the comments so far. I wish that Florida legislators would wake up. The situation here in Florida is never gonna improve until they allow NPs the right to practice independently of physicians this will spread out the availability of primary care providers and I believe will help the shortage we currently face.

I also feel that the Board of Nursing needs to be stronger in advocating for anti-competitive laws that clearly fall in line with the most recent FTC report that demonstrated limits on NP licensure requiring physician supervision/collaboration do not protect the public (as the medical community would have you believe) as there has been no evidence to prove this.

It's all a sea of lies disguised as protectionism to protect their dollar and their pocket.

keischa June 28, 2014 12:15 PM
Plant City FL

The Florida Board of Nursing must learn to stand up to represent its own people and protect them from restriction to practice. The risks to their own population is worsening. Florida has the top five cities in the USA with highest rates of HIV. There are not enough clinics there providing services and few providers likely rare use of NP's. That is Florida. Welcome to the Sunshine state with the highest geriatric population growing also needing services, yet denying them primary care providers. Where is their nurse practitioner? In another state with the right to practice independently with excellent outcomes better than Florida.

Janet Thurston June 28, 2014 1:18 AM
MT

Great article by Dr. Cash, especially the Facts about healthcare provided by NPs.

K, FNP-C June 25, 2014 8:20 PM
Idaho Falls ID

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