Your voice: Nurse practitioners are critical providers of patient care

Your article (“The value of nurse practitioners to medical practices”, August 8th) correctly cited the number of nurse practitioners (NPs) is on the rise. While more patients are choosing NPs as their provider, conducting over a billion visits annually, the article misses the mark on a handful of key points.

NPs have been providing primary, acute and specialty care to patients of all ages and walks of life for nearly half a century. NPs’ abilities to assess patients, order and interpret diagnostic tests, make diagnoses, and initiate and manage treatment plans, including prescribing medications, make us neither mid-level nor an extension of our physician colleagues, rather a critical provider of patient-centered care.

Second, the assertion that NPs merely exist to free up time for doctors undermines the value that NPs bring to health care cost management. Numerous studies have documented that patients seen by NPs have lower readmission rates and are more likely to adhere to plans of care - two important factors in bending the cost curve and improving the quality of life for patients.

Lastly, there was no mention of the prevailing trend of states which have modernized their scope of practice laws to allow NPs to practice to the fullest extent of their licensure and training. As evidenced in recent analysis, nine of the top 10 best states for health care (as measured by outcomes, costs, and accessibility) have enacted such laws, known as full practice authority (FPA). Interestingly, nine of the bottom 10 still limit patient access to NPs by keeping collaborative agreements and other restrictive measures in place.

While we appreciate the interest in gaining perspective on the value of NPs to medical practices, it is these facts which matter most to your audience and patients alike-especially when considering choosing an NP for primary care.

Joyce M. Knestrick, Ph.D., C-FNP, APRN, FAANP
President, American Association of Nurse Practitioners

Physicians, not payers, should control prior authorizations

Since when did physicians allow insurance companies to decide what medicines a patient can have? Insurance companies are playing with patients’ lives.

The idea of a “prior authorization” is demeaning, and intensely frustrating. This is why doctors are burned out. I want our medical associations to reverse this so that an insurance company needs MY prior authorization to change any medicine that I prescribed. Let them ask me if it’s OK to give the diabetic patient Trident instead of Januvia. My prescription order should mean something after the years I went to medical school to earn the privilege to write it!

Gayathri Raju, DO
Hoffman Estates, Ill.