Safriet Federal Options for Maximizing the Value of APRNs

Safriet Paper Review
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Safriet Paper Review Article Overview The article by Barbara Safriet offers knowledge on how state-led limitations about the approved advanced practice nurses (APNs) scopes of practice restrict their full practice (Safriet, 2011). It highlights the policies as limiting provisions to the full exploitation of APNs in medical practice. The paper discusses the advantages of employing APNs to the fullest extent possible and the present constraints that APNs face in their work. As a result, this essay explores two regulatory rules that prevent APNs from being fully deployed in today’s healthcare system and three significant reasons for the present hurdles to removing restrictive policies for NPs. In addition, it discusses the article’s relevant information in APN practice. Regulatory Provisions (Restrictions) to the Deployment of APNs Advanced practice nursing remains limited and has been active for a shorter period. As a result, experts use the medical field to define the scale of individual practice for APNs since the former has been in existence longer. Biases on the concept of medical practice arise in the scale of APNs’ practice, resulting in several frictions and modalities (Moore et al., 2020). Since most physicians in the sector believe that medicine is the highest level of medical care and remain adamant about it, these perceptions have led to regulatory constraints for advanced practice nurses (Peterson, 2017). For instance, in California, the law mandates APNs to collaborate with physicians in their solo or partnered practice. This condition pushes APNs to congregate in physician-led clinics and prevents them from practicing independently, restricting the accessibility and reach of primary care services for more citizens (Parker & Hill, 2017). The strategy contradicts IOM recommendations to increase the reach and reliance of advanced nurse practitioners to satisfy the population’s health care demands. As a result, this regulation limits the APNs’ practice and reduces healthcare availability. Another provision states that new APNs must work for a minimum of 3000 hours with a qualified physician before practicing autonomously. This requirement focuses on more medical training and exposure to a higher level of practice. It remains aligned with people who choose to practice in acute or chronic care environments or pursue greater specialization (Safriet, 2011). Trends indicate that this rule has created a situation where existing physicians influence APNs. Most physicians refuse to oversee APNs since it adds to their heavy workload. As a result, they do not allocate adequate time to teach the nurses. Some physicians also believe that APNs risk their business and professional practice due to increasing competition (Torrens et al., 2020). Such a challenge becomes imminent when APNs gain sufficient medical knowledge for individual practice but stay under physician supervision before venturing into personal practice in retail health clinics (Woo et al., 2017). This issue has become a significant problem since the increasing population will require more medical practitioners per square kilometer in the coming years. Hence, APNs are effective in sustainability models, but their practice remains undermined. Team practice in medical care has also emerged as a significant issue leading to reluctance to help APNs. When physicians object to the growth of APNs, the most prevalent justification is that extending an APN’s position jeopardizes clinical teams’ capacity to collaborate in a doctor-led approach (Schirle et al., 2018). The argument is that the practitioner remains the primary caregiver, and APNs should report to them. However, if a doctor is not available to lead a medical team, APNs can use their advanced training and experience to head such groups today. This recognition irritates physicians, leading to the refusal to teach APNs for the 3000 hours mandated by law due to the competitive nature of the situation. Another angle is that APNs have less knowledge of diagnosis and treatment plans than doctors (Safriet, 2011). This attitude and perception have led to most physicians being reluctant to train APNs in California, resulting in a limited number of nurse practitioners who aid in public healthcare modalities. Thus, this superiority conflict continues to worsen due to the regulation. The policy that payments or reimbursement procedures for Advanced Practice Nurses, whether government or commercially private, do not cater to APNs’ pay processes, preventing them from receiving direct transactions for provided medical services emerges as limiting. Another aspect of this policy is that APNs receive payments at a much lower rate than physicians for similar healthcare services (Schirle et al., 2018). APNs’ payment standards and participation in both commercial and government insurance remain restricted due to the scope of practice constraints. For instance, these professionals receive only 85% of the same amount that doctors get paid for similar services for Medicare. This deducted percentage affects APRNs’ autonomous practice since clinics or hospitals operate with fewer revenues than physician-led organizations (Safriet, 2011). The government’s insurance services only pay for pediatric APRNs, family-based nurses, and conventional midwives. On the other hand, Medicaid does not consider APRNs as primary care providers or illness case managers in their payment process and categories, limiting their practice in the public realm. Obstacles to Removing Restrictive Provisions for APNs Safriet identified three barriers to APN practice: inadequate knowledge of APN roles, abilities, and responsibilities, organized medicine’s perpetual obstruction to increasing medical authority to other practitioners and direct payments to them, and legislation inertia based on conventional and state-oriented licensure schemes (Safriet, 2011). For instance, the repeal of burdensome rules on the licensing of APNs faces barriers from legislative inertia in change. Change necessitates the discovery and study of issues and potential remedies, more crucial discourse in the political scene, and substantial support to execute the proposed APN policies. Given the typical environment in which lawmakers have to act, players fail to adopt a framework that reflects considerable interests. Instead, legislators should formulate policies that efficiently handle situations that demand adjustments in the APRN scope of practice (Torrens et al., 2020). In the case of the licensing practice act proposed regulations, the aspect of delayed legislator discourse occurs. Most lawmakers are familiar with and have involvement in professional wars in the medical field, especially between APNs and physicians, which have regularly happened across the country as different service provider organizations seek changes to their expert practice to improve their delivery (Woo et al., 2017). Licensing rules for APNs have remained stagnant as legislators lag in discussing important issues in the medical sector, making it hard for APN practice in America. Another roadblock to the repeal of constraining regulations is legislators’ and the public’s lack of understanding of APNs’ responsibilities, qualifications, and capabilities. Since the public has traditionally perceived doctors and nurses as having distinct roles and careers, people perceive APNs as underqualified doctors trained to meet demands while ignoring the professionalism and qualifications required in medical care (Gysin et al., 2011). Inadequate publi...