Dr. Marc Watkins: APRNs enable high-quality, accessible health care

As a proud member of Indiana’s retail clinic community, where advanced practice registered nurses deliver affordable, convenient and high-quality care to patients every day, I am compelled to address recent misconceptions about the role APRNs play in our health care system. While some seek to undermine APRNs’ ability to practice independently, the facts tell a much different story: APRNs are indispensable to meeting Hoosiers’ health care needs. Enabling this group to practice to the full extent of their education and training is essential for expanding access to care.

Let’s start with the facts. For more than 50 years, research consistently shows that, within their scope of practice, APRNs provide safe, effective and high-quality care that is comparable to that of physicians. This is not opinion; it is grounded in peer-reviewed studies conducted by reputable organizations, including the National Academy of Medicine, and supported by decades of evidence. States that granted full practice authority to APRNs saw measurable improvements in health care access without compromising safety or quality. In fact, 26 states and the District of Columbia already allow APRNs to practice independently.

In Indiana, the need for APRN-provided care has never been greater. Over 2 million Hoosiers live in areas with inadequate access to primary care providers, and the state ranks 33rd for primary care access and 43rd for mental health access. The federal government designated 138 primary care provider shortage areas statewide. Retail clinics, staffed primarily by APRNs, are uniquely positioned to address these gaps.

The argument that APRNs lack sufficient training is misleading. APRNs are nationally certified and state-licensed professionals who complete rigorous graduate-level education and thousands of hours of clinical training. While their educational pathways and scope of practice differ from those of physicians, APRNs are trained specifically for the kind of patient-centered, holistic care that millions of Americans rely on. Dismissing the value of this expertise is inaccurate and harmful to the millions of Hoosiers who benefit or could benefit from APRN care every year.

Critics often argue that full practice authority does not increase care in rural or underserved areas. However, data from states like North Dakota and Arizona tells a different story. Following full-practice legislation, both states experienced substantial growth in their APRN workforces, particularly in rural regions where access was most needed. For instance, the nurse practitioner workforce in North Dakota grew 83% within six years of passing full practice authority, and in Arizona, the workforce doubled within five years, with a 70% increase in rural areas.

Current APRN licensure rules in Indiana have an anti-business impact that costs jobs, increases taxpayer costs and lowers outcomes. Research demonstrates that removing unnecessary practice restrictions would lead to the creation of approximately 4,000 jobs while saving taxpayers as much as $400 million, conservatively. Additional research demonstrates that removing excessive practice restrictions will result in a potential 30% health care workforce increase, while reducing the number of advanced practice professionals who leave the state. Competition and access in health care is good for patients, customers and taxpayers because it boosts innovation, availability and quality while lowering costs.

Hoosiers deserve access to timely, affordable and high-quality care. Retail clinics and the APRNs who staff them are critical to meeting this need. It is time for Indiana lawmakers to prioritize their constituents’ health and pass modernized legislation that empowers APRNs to practice to the full extent of their training.

Granting full practice authority is not just about health care; it is about ensuring every Hoosier can lead a healthier, more productive life.•

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Watkins is the chief medical officer at The Kroger Co.