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NAPNAP Responds to AMA's Archaic Position

The National Association of Pediatric Nurse Practitioners (NAPNAP) is deeply disappointed that the American Medical Association (AMA) continues to support a national strategy and public campaign to oppose advanced practice registered nurses (APRNs) practicing to the full extent of their education and professional certification. The safe provision of patient care by APRNs is not an issue, though the AMA contends otherwise. Decades of high-quality research has clearly demonstrated that APRNs provide safe, cost-effective advanced practice nursing care. The prestigious Institute of Medicine (IOM), now the National Academy of Medicine, advocates for APRNs to be full provider partners in patient care. The 2010 report “The Future of Nursing: Leading Change, Advancing Health” states that health care access for millions of patients would be compromised without the contributions of APRNs and other equally qualified non-physician providers.

It’s been almost eight years since the IOM report. It’s far past time for state and federal legislators and the entire healthcare system to disavow tired, fear-based, false messages. It is time to embrace the undeniable fact that APRNs and physicians can co-exist as equal colleagues with their own unique scopes of practice. This is the essence of patient-centered, team-based health care.

For 50 years, APRNs have been working to fill provider gaps and hold down costs. We gladly do this in tandem with but not subservient to our physician colleagues.

The public’s understanding of healthcare has evolved dramatically in the last decades, and evidence supports that the best health outcomes result from shared decision making in team-based settings where patients and families are the cornerstone of the decision-making process. The AMA continues to embrace the older system of team-based and patient-centered care where physicians are the sole leaders, an unwise premise because of the chronic shortage of primary care, specialty and sub-specialty physicians. Nurse practitioners provide much needed patient access, particularly in underserved and rural areas. Research demonstrates that patient access is greatly improved when APRNs can practice to their full scope of practice. On the economic side, physician supervision of APRNs duplicates healthcare provider efforts, which results in added cost and delays. Physician supervision does not automatically add to patient safety. In many cases, it is simply supervision for the sake of control and revenue.

NAPNAP calls on state and federal legislators and healthcare systems to see the AMA’s position for what it is: an archaic, duplicative, expensive physician-control issue that is not founded on improving patient outcomes and the overall healthcare system. NAPNAP will continue to advocate for the health and well-being of children and their caregivers, and advancing the APRN profession through high-quality graduate academic education, evidence-based practice and continuous quality improvement. NAPNAP will continue to work actively with all willing partners to remove barriers for children’s access to the high-quality, evidence-based advanced practice nursing care provided by pediatric-focused nurse practitioners in all 50 states and territories.

Nov. 21, 2017