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The Louisiana State Capitol, Wednesday, June 5, 2019, in Baton Rouge, La.

A letter published on May 4 misrepresented and inaccurately described the consequences of House Bill 495. This bill would give nurse practitioners and certified nurse midwives full practice authority after transition-to-practice requirements are met. Contrary to what is stated in the letter, it does not change the scope of practice for nurse practitioners and certified nurse midwives.

In her letter, Dr. Katherine Williams writes, “The best way to ensure patient safety is to keep physicians at the helm of the health care team.” In fact, a large body of research demonstrates the safety and high quality of maternity care provided by certified nurse midwives. The New Orleans Maternal and Child Health Coalition summarizes this evidence in a white paper (2020). Over 40 additional publications supporting the quality of nurse practitioner practice are at the American Association of Nurse Practitioners website.

Throughout the letter, she misrepresents what is known about the care provided by nurse practitioners. For instance, she mentions two studies — we assume she is referring to studies by Lohr et al. (2013) and Hughes et al. (2015) — in a statement about potentially higher costs of care incurred by patients seen by nurse practitioners. These studies assess referrals and orders, and do not evaluate patient health outcomes or costs.

The unfounded concern about opioid prescribing practices is a moot point since opioid prescriptions by both nurse practitioners and physicians are continually monitored by the Louisiana Board of Pharmacy’s Prescription Monitoring Program.

She also claims that there has been, “no noticeable increase of nurse practitioners within rural, underserved areas,” contradicting evidence from a study by Barnes et al. (2018) of a 7% increase in nurse practitioner presence in rural settings.

HB495 eliminates an unnecessary financial and bureaucratic burden that deters qualified health care professionals from practicing in Louisiana. Most importantly, it will improve the health of the people of Louisiana.

CLARE DANIEL

administrative assistant professor, Tulane University Newcomb Institute

MAEVE WALLACE 

assistant professor, Tulane University School of Public Health & Tropical Medicine

New Orleans