NPs: Simple solution for diabetes epidemic

Although Arkansas has led the charge for health reform in the southeast, we find ourselves in the midst of a deadly diabetes epidemic influenced greatly by a shortage of health care providers, and with millions of Americans enrolling in coverage for the first time under the Affordable Care Act, many Arkansans with diabetes will find primary care to be even further from reach. If the demand for health care is ever to be met, expanding the role of nurse practitioners is likely to be a necessary contribution.

In 2012, 26 out of every 100,000 Arkansans were hospitalized for uncontrolled diabetes with no complications. That's 497 percent of the national benchmark, according to the National Healthcare Quality and Disparities Reports. Arkansas has a higher rate of diabetes hospitalizations than any other state in the region, with the exception of Florida -- the only state with more restrictions on NPs than Arkansas.

Research from the Arkansas Center for Research in Economics showed that states allowing NPs to practice to the full extent of their education tend to have lower rates of uncontrolled diabetes. For states like Arkansas with high rural-based populations, this is critical, since NPs are more willing to practice in rural and underserved areas, as shown in studies from Annotated Family Medicine and Journal of the American Academy of Nurse Practitioners.

Scope of practice regulations were originally written to protect patients from inexperienced providers, but a 2005 study in the Cochrane Database of Systematic Reviews showed that NPs are capable of providing preventive care comparable to that of physicians. The National Governors Association concluded that NPs were found to have equal or higher rates of patient satisfaction than physicians, likely due to the increase in time spent with patients during visits. Of all the studies reviewed, none suggested that NPs had worse outcomes or were less effective than primary care physicians.

Many physicians may be uneasy about increasing the role of nurse practitioners, but in 2010, the Institute of Medicine showed that increasing nursing scopes of practice did not diminish the critical role of physicians in patient care or physician income. A 2012 study in Nursing Research and Practice supported this conclusion.

Regulations originally aimed at improving welfare have remained static for so long that they now endanger the lives of citizens intended to be protected under their provisions. Over-burdensome and redundant restrictions on health care professionals limit the number of willing providers, while hindering the public from seeking out adequate preventive care for treatable conditions. Granting full practice authority to Arkansas' NPs will go a long way in keeping our people alive and healthy.

EDITOR'S NOTE: Zachary Helms, a native of Hot Springs, is a health care policy analyst at the Arkansas Center for Research in Economics at the University of Central Arkansas.

Editorial on 07/02/2015

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