Allowing nonphysicians to provide physician-level care would be a step in the wrong direction. Legislators must understand that by passing House bills 495 and/or 442, they risk patient safety, increase costs and do not improve access to care.
The best way to ensure patient safety is to keep physicians at the helm of the health care team. Patients deserve the most qualified health care provider, and that is a physician, who has unmatched training, education and experience.
Scope of practice changes do not decrease costs, nor do they increase access to care. Studies from the Mayo Clinic and Journal of the American Medical Association found nurse practitioners and physician assistants are more likely to make unnecessary referrals and imaging orders, resulting in higher costs for patients.
A study in the Journal of the American College of Radiology, which analyzed skeletal x-ray utilization for Medicare beneficiaries from 2003 to 2015, found ordering increased substantially — more than 400% by NPs and PAs during this time frame. They further found greater coordination in health care teams may produce better outcomes than merely expanding scope of practice.
A 2020 study published in the Journal of Internal Medicine found that in states that allow independent prescribing, NPs were 20 times more likely to overprescribe opioids than those in prescription-restricted states. Furthermore, while the number of NPs doubled between 2010-2017, there has been no noticeable increase of nurse practitioners within rural, underserved areas.
A recent study confirmed few nurse practitioners choose to work in rural areas following graduation. It’s clear: Scope of practice changes do not benefit patients, they benefit for-profit entities and nonphysicians. Legislators must see past the false promises and oppose HB495 and HB442.
KATHERINE WILLIAMS, MD
president, Louisiana State Medical Society