Letters: Nurse practitioners helping to address shortage of primary-care clinicians


In the recent article “Scope-of-practice bills stoke debate over caregivers’ roles,” the American Medical Association applauded the defeat of legislation in New Jersey that would expand patients’ access to care, in favor of stagnant regulations that needlessly strain the healthcare system. Their opposition ignores the primary-care crisis in America and a time-tested solution.

According to HHS, 80 million Americans lack adequate access to primary care, especially in rural areas. At the same time, the primary-care workforce is shrinking. By 2030, it is estimated that the country will face shortages of more than 120,000 primary-care physicians.

It is critical to acknowledge that there is an obvious solution to this crisis facing our country—270,000 licensed nurse practitioners. NPs are the healthcare providers of choice for millions of patients across the country. The confidence these patients have in NPs is evidenced by more than a billion visits made to NPs annually.

Fifty years of data affirms the safety and quality of NP-delivered care. Today, 8 of the top 10 healthiest states grant NPs full practice authority, while the 10 least-healthy states cling to outdated policies espoused by organized medicine, which limits patient access to care.

NPs should be empowered to practice at the top of their license, which reduces hospitalizations and readmissions, and improves healthcare outcomes.

To suggest that only physicians deliver quality primary care is both misleading and disingenuous. NPs and policymakers are working together to ensure all patients have access to the provider of their choice. We call on physicians to stop protecting the broken status quo and start partnering with us to ensure patients get full and direct access to timely healthcare services.

David Hebert
American Association of Nurse Practitioners

Regarding the article “ONC’s Rucker: Lawsuits show hospitals don’t care about privacy,” hospitals say that they oppose the Trump administration’s proposed interoperability standards because they’re concerned about patient privacy, but HHS’ top health IT official said lawsuits over medical debt show that’s not true.

Somehow one-third of Virginia hospitals garnishing wages to collect debt, as noted in the article, does not sound like a small number if you multiply that across the nation, assuming Virginia reflects what is happening elsewhere.

Third-party apps could be required to be HIPAA-compliant, so I am not sure their use is a very good argument against interoperability.

I also don’t think interoperability or its lack really influences where patients choose to get care. But I’m still shocked that a doctor at hospital A can’t pull up a patient’s records at hospital B in the next town over, since it is all on computers.

The real issue that needs to be addressed is hospital computer security. The fact that hackers can put a hospitals data up for ransom is horrendous. People who do such things should be charged with attempted murder, because that is exactly what they risk.

The weight of the federal government should be brought to bear on facilitating hospital data security and tracking down those who violate it intentionally for personal gain.

Dr. Martin Hudzinski
Medical director
South Mountain (Pa.) Restoration Center

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