Letters: Physician lobby is wrong about APRNs

The proposed Indiana legislation that was the subject of a Feb. 10 column in IBJ does not lift limits on tasks that advanced practice registered nurses perform, as the authors erroneously suggest [“Dr. David R. Diaz and Dr. Brian S. Hart: To bring costs down, keep physicians in charge of care.”] Giving patients full access to APRNs will bring health care spending down.

In addition to the misinformation about APRN education the authors conveyed, the studies referenced are irresponsible and unscientific. The Stanford-led “quasi-experiment” is not peer-reviewed, while the Hattiesburg study written by physicians does not use statistical analysis. Both studies include reviews of less than 160 nurse practitioners out of more than 355,000 nationwide. Over 50 years of research supports APRNs’ high-quality care, including studies by the National Academy of Medicine, American Enterprise Institute and Robert Wood Johnson Foundation.

The authors claim that legislation will alter scope of practice for APRNs. This is a false scare tactic used by organized medicine. The bills do not expand the services APRNs can provide patients. It simply removes a contract requirement for APRNs, often costing thousands of dollars per year, stating a physician will review 5% of prescriptive charts. This often occurs months after care has been delivered and has no impact on patients. This makes it hard for APRNs to establish practices in underserved and rural areas, leaving patients with limited access to basic care.

Over 2.4 million Hoosiers lack access to primary care, and 6.6 million can’t access mental health care. Indiana’s 9,000 APRNs stand ready to help expand access. Senate Bill 213 and House Bill 1330 are supported by statewide groups including the Indiana Chamber of Commerce, Indiana Farm Bureau, Americans for Prosperity, AARP and many others. Rather than oppose no-cost, no-delay solutions to address Indiana’s health crisis, the physician lobby should put Hoosiers first. Indiana should join more than half the states in the nation who’ve passed similar legislation.

—Caitlin Krouse

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