Nurses trained in Advanced Practice are quality providers

"...value-based models that emphasize getting treatment in the right place and at the right time. That tends to mean care is given upfront in a primary care setting where nurses are on the front lines."

This Forbes article (below) describes an unfortunately dicey situation between Advanced Practice Nurses (APRNs) and the American Medical Association.  This unnecessary and unproductive difference of professional opinion risks eroding decades of progress made between physicians and nurses about how to implement best practices for quality patient care and positive health outcomes.

Nurses Say AMA Launching 'Turf War' Over Direct Patient Access ~ Forbes article by Bruce Japsen

Nurses across the U.S. are upset at new American Medical Association policy opposing efforts to allow advanced practice registered nurses to practice independently of a physician’s supervision.

The AMA opposes "the continual, nationwide efforts to grant independent practice . . . to non-physician practitioners” including advanced practice registered nurses (APRNs), the nation's largest doctor group voted at last week's AMA policy-making House of Delegates interim meeting. The move is designed to intensify the AMA’s lobbying agenda through model legislation in Washington and state capitals “to initiate creation of a consistent national strategy.”

The development of a new AMA national lobbying strategy comes as APRNs are seeing states and branches of the federal government allow more direct access to patients without a physician’s supervision. A year ago, for example, the Department of Veterans Affairs grantedveterans access to advanced practice registered nurses in a landmark decision.
The American Nurses Association accused the AMA of perpetuating “the dangerous and erroneous narrative that APRNs are trying to ‘act’ as physicians and are unqualified to provide timely, effective and efficient care.” There are four APRN roles: 

• nurse practitioner
• clinical nurse specialist
• certified registered nurse anesthetist and 
• certified nurse midwife

“(APRNs) practice advanced nursing, not medicine, in which they regularly consult, collaborate and refer as necessary to ensure that the patient receives appropriate diagnosis and treatment,” ANA President Pamela Cipriano said in a statement. 

“For AMA to imply that APRNs are incapable of providing excellent care or that their care puts the patient at risk is blatantly dishonest. The future of health care calls on all health care professionals to work together as a team to meet the growing demand for health care services.”

Increasingly, states are easing restrictions to allow patients direct access to APRNs such as nurse practitioners as a way to get patients low-cost primary care, particularly in areas of the country that lack providers of medical care. South Dakota earlier this year became the 22nd state to allow nurse practitioners to practice independently, no longer requiring supervision by a physician as momentum builds to give NPs full practice authority.

Several nurse groups including the ANA and American Association of Nurse Practitioners (AANP) say the new state and federal laws allowing direct access are often efforts to speed care to patients that is slowed by bureaucratic red tape and not an effort to take business away from physicians. Rather, increased access to APRNs is in keeping with the U.S. health system’s move to value-based care models.

Government and private insurers including Aetna, Anthem, UnitedHealth Group and Blue Cross Blue Shield plans are moving away from fee-for-service medicine to value-based models that emphasize getting treatment in the right place and at the right time. That tends to mean care is given upfront in a primary care setting where nurses are on the front lines.