Dear AAPS Members and Friends in New Jersey:
The New Jersey legislature is considering allowing non-physicians (specifically, Advanced Practice Nurses (APNs)*, including nurse anesthetists) who have significantly less training than MDs and DOs, to provide medical care to patients without supervision by doctors.
This is a step in the wrong direction. Supporters claim that the proposal is intended to address the serious shortage of physicians. But rather than actually solving that problem, what the legislation will do is increase the likelihood that patients will be pushed by insurance company bureaucrats and hospital administrators to be treated by someone other than a physician.
Instead of deeming lesser trained practitioners to be on par with physicians, the legislature could be exploring solutions that actually increase the supply of physicians, by working to reverse failed policies contrary to that goal.
Ask your legislators to oppose Senate Bill 1522 and Assembly Bill 2286. Tell them that while you support increasing patient access to high quality care, S1522 & A2286 will not accomplish this goal. Instead they will give insurers, and other bureaucrats, another tool to cut corners and degrade the quality of medical care patients receive. There are better options that increase the supply of physicians, like bills being considered in other states to address a growing shortage of training positions for medical school graduates.
You can get a message to your legislators on the way with a few clicks at the following link: https://p2a.co/YibixqN
What would be a better path? Increasing the number of physicians.
Nationwide, the physician shortage is exacerbated by a deficit of residency program slots for medical graduates. Approximately 8,000 applicants per year to U.S. residency programs currently fail to obtain a match after graduating from medical school.
A complete resolution to the lack of training spots means tackling a number of flawed federal policies, but in the meantime there are important state-based solutions that can be implemented to help.
One exciting proposal that has been enacted, Arizona’s SB 1271, allows unmatched medical school graduates — with a degree of MD or DO and who meet other high standards — to train and practice in certain medical care settings in the state, under the supervision of, and in collaboration with, licensed physicians. Missouri led the way by becoming the first state to implement this type of license, and it is enhancing patient care in the state.
New Jersey should consider legislation like this too so these medical school graduates have an opportunity start on their post graduate training. In addition, patients will gain expanded care options from MDs and DOs.
“At the point of certification, a new nurse practitioner has acquired between 500 and 1,500 hours of clinical training, fewer than a third-year medical student,” reports the Primary Care Coalition. Medical school graduates, by comparison, on average complete 6,000 hours of such training by the end of their 4th year. So allowing MD and DO medical graduates the ability to have limited practice opportunities is a common sense step NJ can and should take as soon as possible.
For more background information on the scope of practice issue, see Physicians for Patient Protection, https://www.physiciansforpatientprotection.org/does-science-support-np-independence.
Thank you for speaking out. Your voice makes a difference.
*”On November 1, 1999, Advanced Practice Nurse became the title in New Jersey for Nurse Practitioners and Clinical Nurse Specialists.” (source)