Health Policy or Politics?
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.