Debunking Myths that NPs Increase Rural Access and Lower Costs

The “increased rural access” and “lower cost” rhetoric used to support nurse practitioner autonomy is a complete fallacy and there is zero data to support these claims.  

1.  The market factors that make it difficult for physicians to practice in rural, underserved areas is not any different for NPs than it is for physicians.  NPs are not independently more altruistic than physicians.  Poor payer mix and the expense of excessive regulatory burdens will make it difficult for anyone to keep their doors open in these areas.  

2.  Look at the states that have allowed NP independent practice for decades, like Arizona.  NPs are practicing in the exact same places as physicians.  They do not go to rural areas.  There are maps available from AMA that show this quite clearly.  

3.  There are multiple studies that show NPs make more referrals to specialists, order more inappropriate radiology studies, and perform more skin biopsies than physicians.  This all INCREASES cost to the healthcare system.  In practice, I see NPs ordering tons of worthless tests in order to try to bridge the gaps in their knowledge.  They order tests and then have no idea what to do with them which leads to more tests and more referrals.  At a time when we are focused on decreasing unneeded healthcare waste, how does it make sense to use these undertrained non physicians.  

4.  If they are arguing for pay parity, how exactly do they decrease healthcare costs?

Data references demonstrating NPs increase cost and lower quality:

NPs order more biopsies: https://doc-10-58-docs.googleusercontent.com/docs/securesc/500pimnenqerpcb3jog4vu5k5j56276k/f3drubbtuuasggve85q8h4dmet2ru2n5/1570492800000/11904212300552749650/00862855625573411785/1Oa8BCwnGYyN8Qwxg4bk6NYPdEeaQETHw?e=download&nonce=5nnu0081r77o6&user=00862855625573411785&hash=rldhsra0pp9qca2lt28lrf0ccab5h8f2

NPs order more imaging: 
https://doc-04-58-docs.googleusercontent.com/docs/securesc/500pimnenqerpcb3jog4vu5k5j56276k/8gvilblg17297cb1rr7h0rg62tem57o5/1570492800000/11904212300552749650/00862855625573411785/1khlK1Uaw9ZKBES85GxnAICJW9_QUS4qi?e=download

NPs make more referrals to specialists: https://doc-0c-58-docs.googleusercontent.com/docs/securesc/500pimnenqerpcb3jog4vu5k5j56276k/pd0vv46pqfms4l8gfhefl9rtbjsjbnl9/1570492800000/11904212300552749650/00862855625573411785/1BYA0yZwLoHB0ozC8vOL6NVrHnDYj18MI?e=download

Prescribe more antibiotics =more antibiotic resistance: 
https://doc-00-58-docs.googleusercontent.com/docs/securesc/500pimnenqerpcb3jog4vu5k5j56276k/v0hj5lspvacc5qch9p312rn4hruf6b9u/1570492800000/11904212300552749650/00862855625573411785/1ifSQYhGKCQAzwqNWefUS5x7PA2G8HC5C?e=download

More general resources  https://drive.google.com/drive/mobile/folders/1FF7sTKg4XZa_L5mXpW2puGjlMU3BuwcO/1IwfXD0e5Lxk9BuJoPtD2egwQySsozxdS/1z-L86XfVOzW6KPFpolF13ltCEWrI3Vv5/1S3iJlDPUcGBiLZmVgK7CYolis8eiv41i?sort=13&direction=a

 

1 thought on “Debunking Myths that NPs Increase Rural Access and Lower Costs

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.