Can Healthcare Confront Primary Care Access Shortages With NPs?

Expanding scope of practice for nurse practitioners (NPs) would increase the primary care workforce and ideally bolster primary care access, according to AANP’s president, April Kapu.

By Sara Heath

May 15, 2023 – Healthcare is on the precipice of having 100 million people lack access to primary care, a problem that could have catastrophic downstream impacts. But according to April Kapu, the president of the American Association of Nurse Practitioners (AANP), there’s some hope to fill in those workforce gaps.

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Nurse practitioners (NPs), in particular, stand ready to bolster the primary care workforce, said Kapu, an NP herself and a professor at Vanderbilt.

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“As you know, primary care is very important to health promotion, to disease prevention, to be able to detect and do those early screenings,” Kapu said in the latest episode of Healthcare Strategies. “If we are not staying on top of chronic disease management like diabetes and heart conditions, you see more patients going to the emergency room or having more complications.”

There are over 355,000 NPs in the US today, with around 90 percent of them educated, trained, and board certified in primary care, Kapu explained.

And as healthcare chips away at its primary care access woes by tapping non-traditional care sites in mobile health clinics and community health centers, NPs are ready to go, so long as they are not stymied by practice authority restrictions, Kapu pointed out.

These state-mandated rules dictate the extent to which an NP or other advanced practice provider can practice at the top of their training. For NPs, Kapu said this means being able to do the diagnosing, prescribing, ordering, and text interpretation they are trained in.

That would be a big help in ensuring more people could get primary care, she added. With more qualified providers able to freely treat patients at the top of their training, more patients could access the preventive primary care they need to keep chronic illnesses managed and at bay.

Currently, 27 states have expanded scope of practice to allow full practice authority, so there is a long road ahead, Kapu noted.

“There is a lot of momentum for states to update outdated laws and remove barriers to access to care so that patients in those states have full and direct access to nurse practitioners wherever they are in their communities, whatever setting that they may come across nurse practitioners,” she said.

“We’ve seen more nurse practitioners moving to historically underserved areas, but there are still 23 states that still have outdated laws, and many of those states are listed as having the worst outcomes in the US, heart disease, diabetes, obesity.”