Scoping out health care worker shortages.
In areas where there are not enough doctors and nurses to keep up with the demand for their services--such as rural and underserved urban areas--state legislators are broadening the roles of some licensed health professionals through "scope of practice" laws. Supporters say that expanding the authority of nurse practitioners, physician assistants, dental hygienists and other oral health providers to perform additional procedures, treatments and actions would help alleviate health workforce shortages.
Legislators have considered dozens of bills over the past several years. New Jersey lawmakers, for example, voted last year to allow greater flexibility in the way physician assistants provide care. The law removed the requirement that a physician must always be present and allowed the physician assistant to work with a physician to define his or her personal scope of practice. Maryland and Nebraska passed legislation in 2015 to allow nurse practitioners to practice without physician oversight.
Scope of practice bills often bring out passionate advocates with different points of view. Proponents of these laws say licensed professionals can be trained more quickly and less expensively than physicians without compromising quality. Some physician groups disagree and argue that physicians' longer, more intensive training equips them to diagnose more accurately and treat patients more safely.
For those interested in more information, there's a new website created by NCSL and the Association of State and Territorial Health Officials that focuses on scope of practice policies for nurse practitioners, physician assistants, dental hygienists and dental therapists in all 50 states, D.C. and the territories. Find it at www.scopeofpracticepolicy.org.
Caption: Where the Needs Are Greatest
Primary Care Health Professional Shortage Area Scores by County
Scores range from 1 to 25: the higher the score, the darker the color, the greater the shortage. Scores are based on the population-tohealth provider ratio, the percentage of low-income population, the travel time required to reach a source of health care, as welt as infant mortality and low-birth rates.
Source: Health Resources and Services Administration Data Warehouse
The Rural-Urban Divide (Per 100,000) Rural Urban Primary Care Doctors 40 53 Nurse Practitioners 28 36 Physician Assistants 23 34 Dentists 22 30 Specialists 30 263 Population Over Age 65 18% 12% Sources: Health Resources and Services Administration and Rural Health Information Hub, the Rural Health Research Center at the University of Washington, 2016. Legislation Expanding the Roles of Health Professionals Bills Introduced and Enacted between 2015 and 2016 Bills Introduced Bills Enacted Oral Health Providers 39 7 Nurse Practitioners 68 9 Physicians Assistants 36 10 Source: Scope of Practice Policy at www.scopeofpracticepolicy.org. Note: Table made from bar graph.
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|Date:||Mar 1, 2017|
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