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Let the Nurse Practitioners Work

Retail health clinics and nurse practitioners could together dramatically lower the costs of US health care, according to a new study published in Health Affairs. Allowing nurse practitioners to work autonomously in retail clinics could amount to big savings:

It is estimated that retail clinics will account for about 10 percent of outpatient primary care visits in 2015. If NPs do not have any practice independence, the cost savings in that year from retail clinic use would be an estimated $2.2 billion. Note that this figure is consistent with another economic analysis that estimated that national cost savings from retail clinics could be $1.8 billion in 2014. According to our calculations, savings would be $810 million greater if all states allowed NPs to practice independently and $472 million greater if NPs could both practice and prescribe independently.

Those who argue against granting more powers and discretion to nurse practitioners usually claim that quality or safety of care would decline if we did so. But this study confirmed earlier findings that quality of care by nurse practitioners is roughly the same as the quality provided by physicians. With every new study like this that’s published, there’s less and less reason for state legislatures to block bills expanding the scope of practice for nurse practitioners.

As America runs out of doctors, a more autonomous corps of nurse practitioners could lower costs and ensure that the elderly, the newly insured, and those with chronic conditions get the care they need.

[Photo of stethoscope and money courtesy of Shutterstock]

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  • Maynerd

    Unfortunately, the details of the study, beyond the abstract, are behind the “Health Affairs” journal fire wall.

    I am a specialist MD and not a primary care physician. Count me as skeptical that large savings exist using mid-levels (NP’s and PA’s) as surrogate primary care physicians. My specialist colleagues all bemoan the unnecessary imaging, lab work, and specialty consultation generated by the relatively insecure and inexperienced mid-levels. It would be interesting to add up the total global cost to the health care system of a mid level vis a vis an MD.

    The premise that a few years of training is equivalent to 4 years of uber intense medical school and three additional years of residency is comical.

    For all of who advocate this wonderful frugal approach please walk the walk. Discard your child’s pediatrician and your internist and embrace the nurse practitioner. I’m confident you will enjoy the fruits of our brave new and improved health care system.

    • Andrew Allison

      Where to begin? With your blatant self-interest? Or with your ridiculous assertion that “the unnecessary imaging, lab work, and specialty consultation” is not generated
      by CYA MDs?

      The fact is that for most primary care (with which you acknowledge you are unfamiliar), NP’s and PA’s are at least as well qualified as MDs. As a recipient, rather than a provider, of healthcare, it’s my impression that the so-called “mid-level” practitioners are more, rather than less, likely to recognize when they need to make a referral.

      • Maynerd

        You seem a bit hostile. But that’s OK. As I stated, go ahead and enjoy the new system.

        Regarding my “blatant self interest”, mid levels increase my work and therefore my income. And that is my point. Mid levels drive up the cost of health care by their lack of training and experience. Not to mention the increased liability costs they generate.

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