Remove Outdated Nurse Practitioner Practice Barriers In Michigan - SB 279

Thoughtful commentary from Denise Soltow Hershey in Crain's Grand Rapids Business:

https://www.crainsgrandrapids.com/news/commentary/commentary-remove-outdated-barriers-to-practice-for-michigans-nurse-practitioners/

Commentary: Remove outdated barriers to practice for Michigan’s nurse practitioners
By Denise Soltow Hershey -July 10, 2023

Michigan is struggling to resolve a serious problem — limited access to basic medical care in rural and urban areas across the state due to a shortage of health care professionals, especially primary care physicians and nurses. As more doctors choose to practice in specialty areas, experts project that Michigan will have 1,000 fewer primary care physicians than needed within the next few years.

Nursing talent also is in high demand right now, with some health systems offering signing bonuses of $10,000 or more to fill out their staff. Yet Michigan remains one of a dwindling number of states with outdated laws that limit our state’s ability to attract and retain the most highly trained and experienced nurses — nurse practitioners. Allowing nurse practitioners to do their job without onerous, unnecessary restrictions should be part of the solution to Michigan’s troubling shortage of primary care providers.

Nurse practitioners are advanced practice nurses who receive a masters or doctoral degree in a specific specialty area. These areas include family, neonatal, adult-gerontology, pediatrics, psych-mental health and others, with a focus in primary or acute care. Over 80% of nurse practitioners practice in primary care, delivering thousands of direct patient care visits each year in Michigan, and are more likely to practice in health care shortage areas. Most nurse practitioners have more than seven years of education and training.

Many patients don’t realize that their nurse practitioner — who is nationally certified and has years of clinical experience — is required by state law to secure a contract with a supervising physician. Only 11 other states still put this onerous restriction on nurse practitioners. Even worse, nurse practitioners must pay their physician collaborators as much as $4,000 per month for the right to serve patients. You read that correctly. Nurse practitioners are required to pay for the privilege of doing their job.

Physicians and their advocates claim that allowing nurse practitioners to practice autonomously creates a lower-quality tier of medicine. In fact, over 30 years of data shows that nurse practitioners provide high quality and safe care, and that patient satisfaction is the same or higher than the care received from a physician. State-mandated contracts also limit nurse practitioners to practicing in areas where they can secure a contract with a physician, reducing access to care in the very areas where health care providers are needed most.

As a family nurse practitioner with over 25 years of experience in both rural and urban settings, I routinely collaborate and consult with physician colleagues to achieve the best outcomes for my patients. Ironically, this consultation often is not even between me and my supervising physician. As an assistant professor in the MSU College of Nursing, every year I also see new graduates leave Michigan so they can practice in a state with less burdensome restrictions on nurse practitioners.

Bipartisan legislation recently introduced by Sen. Jeff Irwin (D-Ann Arbor) and Sen. Rick Outman (R-Six Lakes) removes the requirement that nurse practitioners must have a state-mandated contract with a physician. Senate Bill 279 is supported by the Michigan Health and Hospital Association, Michigan Primary Care Association, AARP, Michigan Association of Health Plans and many others because they know it will help ease Michigan’s health care provider shortage, reduce health disparities, and improve access to quality, safe and affordable medical care across the state.

It’s time for Michigan to join 27 other states that allow full practice authority for nurse practitioners. I encourage Michigan’s legislative leaders to approve this important bill and send it to Gov. Gretchen Whitmer to be signed into law.

Denise Soltow Hershey is an assistant professor at the Michigan State University College of Nursing and chair of the Michigan Council of Nurse Practitioners’ legislative tasks force.