Viewpoint: Modernized care means lifting limits on nurses, PAs

To modernize healthcare practices, regulations limiting nurses and physician assistants should be revised, according to a perspective piece published Feb. 12 in The New England Journal of Medicine. 

Authored by eight directors of health workforce research centers, the commentary suggested states implement the same scope-of-practice laws and regulations across health professions.

The authors' collective research hasn't found anything to support claims that relaxing scope of practice for nurses harms patients, Bianca Frogner, PhD, director of the Center for Health Workforce Studies and an associate professor at Seattle-based University of Washington School of Medicine, said in a news release. She said most studies find that relaxing scope of practice expands access and the quality of care is the same as that delivered by physicians.

Laws and regulations are influenced by professional organizations and lobbyists interested in protecting their own professional standing instead of patients' access to care, the authors wrote.

PAs, nurse practitioners and community pharmacists, for example, could counteract the psychiatrist shortage by providing medication-management services, the authors contended. Licensed practical nurses and home healthcare aides could complete tasks for which they currently have the capacity, but RNs do not have the scope to delegate the tasks to them.

"Such regulations lock up the capacity of professionals, which is wasteful and contributes to increasing costs," said Peter Buerhaus, PhD, RN, senior author, healthcare economist and director of the Center for Interdisciplinary Health Workforce Studies at Bozeman-based Montana State University.

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