An Easy Way to Give Arkansans Wider Access to Health Care

It would be difficult to find a politician for state or federal office who doesn’t talk about improving health care. In many cases, the way these politicians propose doing that is by expanding a government program like Medicaid or Medicare. But there are other ways to make the Arkansas’s health care system better. One of them is to expand the ability of health care professionals to do their jobs.

That’s what David Mitchell, director of the Arkansas Center for Research in Economics, suggested in a recent op-ed for the Democrat-Gazette. He says that if Arkansas would give nurse practitioners (NPs) more freedom to serve patients, it would expand access for health services at lower costs. As he points out, this is working in other states:

Twenty-one other states allow nurse practitioners full practice to provide primary care; Arkansas legislation restricts nurse practitioners from practicing to the full extent of their training. Our scope-of-practice laws require NPs to be supervised by a physician. This adds unnecessary paperwork and expense.

Some fear that loosening restrictions on NPs would harm patients. According to the evidence, this just isn’t so:

A systematic study of 25 articles relating to 16 studies found that patients assigned to either nurse practitioners or primary-care physicians have comparable health outcomes. That means that nurse practitioners without physician oversight tend to do as well in treating, diagnosing and prescribing medication to patients as those with physical oversight…

Some worry that advanced-practice clinicians like NPs might have worse results than physicians or be practicing inferior medicine. Yet a randomized trial published in The Journal of the American Medical Association (JAMA) between physicians and nurse practitioners showed that nurse practitioners provide equivalent care. JAMA is the premier peer-­reviewed medical journal. A follow-up in Medical Care Research and Review confirmed that there was no difference between the groups in terms of primary-care health outcomes.

While many services should be performed by doctors, there are also many services that can be performed by other health care professionals. Nurse practitioners, physicians’ assistants, pharmacists, dental hygienists, and others can do a range of tasks that improve patients health – but only if state law allows them to do so.

Too often, laws place tight restrictions on what these professionals can do. That ensures that patients must go to doctors or dentists to receive care. That may be good for doctors or dentists, but it is not necessarily good for patients. In fact, these restrictions create an unnecessary bottleneck in the delivery of health care services, which raises costs and produces longer wait times. In rural areas, these laws could be the contributing factor in the lack of overall health care services.

It’s time that Arkansas join the other states that give nurse practitioners the power to provide primary care. If we want Arkansans to have more access to care, then it makes sense to remove legal restrictions on providing that access.

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