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Jerod Smith: Health care crisis? There's an APP for that

| Saturday, Dec. 8, 2018, 6:03 p.m.
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Dr. Gene Battistella ( “Pending bills could impact patient care in Pa.,” Oct. 3, TribLIVE) maintains that the number of clinical training hours for nurse practitioners and physician assistants directly influences a patient’s outcome. This is not true. Studies have compared the practice patterns of nurse practitioners with those of physicians and determined that nurse practitioners performed as well as physicians in all areas of primary care delivery and patient outcomes.

The Federal Trade Commission states that “a growing body of evidence suggests that APRNs (nurses with at least a master’s degree in nursing) can, based on their education and training, safely perform many of the same procedures and services provided by physicians.” I have personally observed that quality education and superior mentors produce excellent professionals in the field.

Battistella anticipates an increase in opioid prescriptions if nurse practitioners and physician assistants gain independent full-practice authority. He forgets that all providers must follow prescription guidelines or risk both losing professional licensing status and facing criminal charges.

He urged lawmakers to “take a step back and consider the unintended consequences that these proposals would have on their constituents.” In response, I say, “I’ve got an APP for that.”

Unfortunately, the current health care environment fails to recognize the value of advanced practice providers (APPs), and this results in underutilization. For our health care system to become not only efficient but also effective, it needs to be intellectually honest concerning the benefits that such providers offer.

American life has adapted to the changing health care environment and, were it not for the polarized fight over health care, the use of APPs would have kept pace as well. Throughout the national debate, two situations have remained constant: the shortage of primary care physicians and an underutilization of APPs.

The United States has nearly 250,000 licensed nurse practitioners and almost 125,000 licensed physician assistants. If properly utilized, the solution to the health care crisis already exists.

The challenge is for APPs to clarify the quality of the care and recognize the scope of the specialties within the profession, thus optimizing the value that an APP provides. By implementing reliable standard measurements, APPs can be a beneficial part of the solution.

The midterm elections made it clear that health care is a major concern. There is general agreement that a successful health care system must have universality, quality and affordability. Properly utilized, advanced practice providers can be the key to having all three. Allow APP programs to grow through clinical experience, mentorship and increased collaboration with physicians, as well as increased autonomy, and what will emerge will be step one in neutralizing the primary care physician shortage.

Jerod Smith, MSN, CRNP, CCRN, is a vascular surgery nurse practitioner and chairman of the Advanced Practice Provider Council for Excela Health Medical Group, Greensburg.

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