Nurse Practitioners Gain Autonomy in North Carolina

I was surprised when I read the news in yesterday’s local paper: North Carolina lawmakers passed the Save Act, a bill giving nurse practitioners autonomy over their practice. That is, they are no longer required to pay physicians to “supervise” them.

I have been following the Save Act, which has failed to become law, over the years. I wrote about this problem in a post in 2019: Barriers to Advanced Practice Registered Nurses.  When the Save Act was last defeated in 2017, NC had the worst health care costs, the 5^th lowest number of NPs, and the 41^st highest infant mortality of all the states. Since then, the infant mortality rose to become the 8^th highest. Forbes ranks NC as the third worse state for health care after Georgia and Alabama.

The have been numerous studies ever since I became a nurse practitioner in 1981 that have over and over again proven nurse practitioners deliver safe and quality care.

Here is a recent study comparing nurse practitioners to doctors in primary care.

Again, the findings offer nothing new.

The level of quality care nurse practitioners provide compared with their physician colleagues in the primary care setting: A systematic review

Abstract

Background: There is an increasing demand for high-quality primary care providers without adequate supply to meet the need. Nurse practitioners (NPs) are uniquely positioned to fill this demand but influence on regulatory practice authority from concerned groups regarding patient safety and quality of care has delayed this as an effective solution.

Objectives: The objective was to address concerns about NP-led care by examining evidence regarding patient safety, clinical outcomes, cost, and patient satisfaction that reflect on the ability of NPs to provide high-quality care within the primary care setting and to compare their ability with standard models of care led by physicians.

Data sources: A systematic review was completed using PubMed, CINHAL Complete, and Scopus. Using PRISMA guidelines to critique literature and the John’s Hopkins Research Evidence Appraisal tool, articles were analyzed comparing the quality of care between NP and physician providers in the primary care setting.

Conclusions: A total of 11 articles met the criteria and reveal that NPs provide equal or better quality of care for all outcomes when compared with their physician colleagues(Italics mine)

Implications for practice: Quality patient care provided by NPs in the primary care setting is equal to, and in several cases superior to, that of physicians. Concerns for patient safety and quality care outcomes seem unsupported by data, and state legislatures should continue to grant full practice authority. as an effective source of providing high-quality primary health care.

Michael BarnettChristopher Balkissoon, Jodie Sandhu. Journal of the American Association of Nurse Practitioners. 2022 Mar 1;34(3):457-464.  

I’m excited the Safe Act finally passed in NC. I expect health care statistics in my state to improve.