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Advocacy for Nurse PractitionersKailey HamrickAuburn University/ Auburn University MontgomeryAdvocacy for Nurse PractitionersNurse practitioners (NPs) are advanced practice nurses who have been educated and certified to evaluate, diagnose, treat, and manage patients across the healthcare continuum. Currently, there is not a standardized regulation defining the role and scope of practice of nurse practitioners, the different regulations are set by the individual states in which the NP practices. In the state of Alabama, legislation states NPs must have a collaborating physician and that the physician must be with the NP for no less than 10% of the NP’s hours as well as visit the collaborative work site quarterly (Alabama Board of Nursing, 2003). Alabama legislation should remove the condition of 10% physician supervision to reduce healthcare costs, improve patient satisfaction, and further the autonomy of nurse practitioners.Elevated healthcare costs have long plagued our healthcare system. Having NPs practice without direct physician supervision can help reduce the financial burden in many ways. According to the Medical Group Management Association (2014), practices that utilize NPs generally have better financial outcomes. MGMA found that physician offices studied had higher compensation, less operating costs, and increased productivity when their practices included NPs (2014). With the new Affordable Care Act, millions of previously uninsured patients will now have insurance and be seeking primary care. This influx will lead to an insufficient number of physicians needed to care for the new patients. NPs can fill in for the projected physician shortages and reduce healthcare costs by functioning as independent advanced practitioners that cost less to employ but work equally hard to provide quality patient care. This access to superior care results in increased patient satisfaction, which in turn also increases revenue.Patient satisfaction stems from multiple factors, a few examples being what the patient expects from their healthcare provider, how they feel during the visit, and if they feel the medical advice was beneficial. As a rule, NPs focus on the entire picture when caring for patients. Unlike many physicians, NPs include a patients’ social and mental needs as well as their physical needs (Institute of Medicine of the National Academies, 2011). NPs also spend more time building a relationship with their patients than physicians, which provides the patient with a greater feeling of satisfaction. The MGMA states that “In primary care practices, [NPs] can provide 80 percent or more of services with equal or better patient satisfaction at a lower cost than a physician. Many times, [NPs] have fewer demands than physicians and are more readily available to patients” (2014, p.15). Being more available, approachable, and holistic are NP qualities that increase patient satisfaction, and in turn improve patient outcomes. Improved patient satisfaction and outcomes cannot be obtained if NPs are not able to practice to their fullest extent. The 10% law implies a hierarchical relationship between NPs and physicians, which damages NPs autonomy (Hamric, Hanson, Tracy, & O'Grady, 2014). Having to report to and by supervised by a physician infers the physician is superior and may lead to NPs relinquishing their opinions in favor of the physicians’ ideas. This could lead to NPs not functioning at their highest competency level and fallouts in patient care.Better patient care is the highest priority of all healthcare workers. In order to obtain the goals of improved patient care and satisfaction and reduced healthcare costs, Alabama legislation must remove the condition of 10% physician supervision and establish autonomy for nurse practitioners.ReferencesAlabama Board of Nursing. (2003). Advanced practice nursing collaborative practice. Retrieved from ABN website:, J.A., Hanson, C.M., Tracy, M. F., & O'Grady, E. T. ?(2014). Advanced practice nursing: An integrative approach (5th ed.). St. Louis, MO: Elsevier/SaundersInstitute of Medicine of the National Academies. (2011). The future of nursing: Leading change, advancing health . Retrieved from Group Management Association. (2014). NPP utilization in the future of US healthcare: An MGMA research & analysis report. Retrieved from ................
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