Viewpoint: Who Will Fill the Health Care Provider Gap?

by Beth Haney
CANP President

During this holiday time of year, it can sometimes seem as if our storefronts and shopping malls are bursting at the seams. Parking lots are packed, lines are long, and inventories run short. However, the retail industry somehow makes it through the season.

It's a decent analogy for our health care delivery system. While there is a tremendous amount of need on a daily basis for health care services, our physicians, pharmacists, nurses, nurse practitioners and other medical professionals work together to address that need.

However, imagine if Christmas shoppers were expected to double in number next year. That demand would require new stores to be constructed, new shelves to be stocked, and new salespeople to be hired and trained.

Similarly, the health care system is gearing up for full implementation of President Barack Obama's Patient Protection and Affordable Care Act, which in just a year's time will extend health benefits to the estimated 50 million uninsured people in the United States.

Nearly 7 million of those uninsured people are here in California and will soon be seeking out health care providers. Simply put, there are not enough medical professionals to address the increased need without the potential of lower standards of care and longer wait times for patients.

That's why state Sen. Ed Hernandez, a health care professional himself, plans to hold legislative hearings next month to examine and understand the workforce demands that need to be met to properly implement the president's health care reforms.

What the Legislature will discover is that nurse practitioners will be needed to help fill the gap and ensure the success of the new health care law.

There are more than 16,000 nurse practitioners in California – advanced practice registered nurses who have completed graduate level education such as a master's or a doctoral degree. The Legislature will find that in many cases they deliver the same high quality of health care as provided by physicians, but often at lower cost.

Both the Institute of Medicine of the National Academies and the National Council of State Boards of Nursing recommend that nurse practitioners and all health care providers be allowed to work to the full level of their education and training to provide the necessary care for our population. Studies published in the Journal of American Medicine and by the Rand Corp. show that, if nurse practitioners are allowed to do so, they provide equal quality of care and health outcomes as physicians.

Obama recognized this. That's why the Affordable Care Act includes funds to increase the number of nurse practitioners throughout the nation as well as establish more nurse practitioner-led clinics.

This is especially important for lower-income communities and underserved populations, such as Latinos and African Americans. In these communities, where physicians already are in short supply, nurse practitioners are addressing routine health care needs and administer preventive medicine that will stave off more serious illness and disease such as diabetes and obesity. They often also treat patients in low-cost clinics rather than in more expensive hospital emergency rooms.

Nurse practitioners are already in the exact places where demand for health services will increase. In California, they work in community clinics and urgent care centers, hospice facilities and nursing homes, school campuses and veterans facilities, hospitals and private practices.

The scope of their work includes things like diagnosing acute and chronic diseases, ordering and interpreting diagnostic studies, prescribing physical therapy and other rehabilitation treatments, and counseling patients on health behaviors and treatment options.

The health and well-being of the patient ought to remain the primary focus at all levels within the health care delivery system. And with nearly 20 percent of California's population soon to flood into the system as a result of the Affordable Care Act, all health care professionals will need to work together to provide a high level of benefit to all patients.

Nurse practitioners will be a vital part of maintaining a high quality of care and ensuring smooth implementation of the new health law.