Everyone Deserves a Dream

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• Heath Care Reform: One Aspect is Working Anytown Newspaper - June 1, 2012
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Occasionally, I hear people make statements that seem factual, but many others question (“I will loan you $20, I know you will pay me back”). My usual response is, “Everyone deserves a dream.” Well, I deserve to have a dream, too. At the time of this writing, my last as ACNP president, health care reform is still an unknown. So below is my dream. I am going to work very hard to make it come true, even though many uninspired people will question its veracity.

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Heath Care Reform: One Aspect is Working Anytown Newspaper - June 1, 2012 

Health care reform hasn't been the panacea that many dreamed, but at least one aspect is working—nurse practitioners (NPs). NPs have been around since the 1960s, but have remained relatively obscure until the explosion of retail clinics, staffed almost exclusively by NPs. Unfortunately, some federal and many state regulations created barriers for NPs, wishing to provide care to their patients in other settings.

As health care reform began to jell in 2009, four things happened to change the tide for NPs. First, a landmark article appeared in JAMA, settling once and for all that NPs provide high quality care. Second, national NP organizations coalesced into a powerful collaborative and flexed their muscles on Capitol Hill. Third, an amazing grassroots effort by NPs and their patients pressured federal legislators and policymakers to include NPs in every aspect of health care reform. Fourth, with federal reform including NPs, states began to follow. A document called the Consensus Model for APRN Regulation, adopted by multiple nursing organizations, provided the framework for state regulation.

With federal barriers removed and state barriers falling, NPs are finally able to provide Americans with comprehensive, health-promoting, wellness-oriented care. A recent study of patients receiving care from NPs found a very high level of satisfaction and, better yet, outstanding health outcomes. Health status indicators for these patients, such as weight, cholesterol, exercise, etc, are significantly better than for those not seeing NPs. As expected, illness system costs (considerably more expensive than health system costs) are also significantly less for this group. Thad Wilson, Special Assistant to President Obama (I told you this was a dream, remember?), said that the outcomes were not a surprise to those who have followed the NP movement. He encouraged NPs and their patients to continue pressuring all government entities to remove barriers to patient choice.