Nurse practitioners look to fill gap with expected spike in demand for health services

“We know that the Affordable Care Act will extend health coverage to millions of Americans,” said Penny Kaye Jensen, president of the American Academy of Nurse Practitioners. “It’s important for consumers to understand what we do and that we’re fully prepared to care for them.”

Through advertisements, public service announcements and events, the organization will try to raise the profile of the country’s 155,000 nurse practitioners.

The campaign looks to exploit what many say is a looming doctor shortage. The Association of American Medical College predicts that the country will have 63,000 too few doctors as soon as 2015.

“With the serious shortage of family doctors in many parts of the country, nurse practitioners — or NPs as they are known — can provide expert, compassionate and affordable care,” the group will contend in a radio public service announcement.

The AANP will follow up on the public relations blitz with state-level lobbying efforts, looking to pass bills that will expand the range of medical procedures that their membership can perform.

“A fully enabled nurse practitioner workforce will increase access to quality health care, improve outcomes and make the health-care system more affordable for patients all across America,” ­Jensen said.

All states have “scope of practice” laws, which regulate what medical procedures each profession can, and cannot, perform, given their level of education. These laws regulate everyone from dental hygienists to physician assistants up to nurse practitioners, who all hold graduate degrees in medical education.

In 16 states, nurse practitioners can practice without the supervision of another professional such as a doctor. Other states, however, require a physician to sign off on a nurse practitioner’s prescriptions, for example, or diagnostic tests.

As the health insurance expansion looms, expanding those rules to other states has become a crucial priority for nurse practitioners. “We’re all educated and prepared to provide a full range of services,” said Taynin Kopanos, AANP’s director of state government affairs.

The nurse practitioners’ campaign, however, is unlikely to move forward without a fight: doctors’ groups have often opposed such efforts of other professional societies to expand their medical authorities. The American Medical Association, which lobbies for doctors, often contends that such laws could put patients at risk.

“Non-physician professionals play vital roles in providing high-quality patient care, but no other health-care professionals’ education and training comes close to physicians’ more than 10 years of medical education and 16,000 hours of clinical experience,” AMA President Peter Carmel said.

Legislative analysts at the AMA say they’ve seen an uptick in state legislation meant to increase the powers of other professionals since the Affordable Care Act passed. Legislators have introduced about 400 such bills this year.

Nurse practitioners say they do have the skills necessary to treat patients with more autonomy. Unlike other nurses, all nurse practitioners hold either a master’s or doctorate degree in medical education.

Alongside the legislative push, the group also will focus on public education. Data suggest that they have their work cut out for them: A 2010 AANP poll found that while most Americans report having been seen by a nurse practitioner, few knew that their medical expertise goes beyond that of traditional, registered nurses, who go through less medical training.

Fourteen percent of the adults surveyed thought that nurse practitioners could prescribe medication, although sometimes with a physician’s supervision, an authority they have in all states. They can also order diagnostic tests and scans, such as X-rays and MRIs, but only 18 percent thought such powers were within their scope of practice.

“People stop at the word nurse and don’t understand the word practitioner,” Jensen said. “Obviously we are nurses, but we also have advanced education. We think there’s a misunderstanding on the patients’ behalf.”

Jensen hopes to see her members out at health fairs, church groups, rotary clubs and other community events to get the word out about the work they do, and the role they hope to fill as health insurance coverage expands.

“I think I was surprised about patients knowing so little, even if they’ve seen us,” she said. “That really was the springboard for this campaign, that we need to be expanding our visibility.”

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Health-care I.T. demand heats up

by Ken Alltucker - Jan. 21, 2012 07:51 PM
The Republic | azcentral.com

The health-care industry has been a major source of new jobs despite the dour economy, and some health-related fields have more job-growth potential than others.

One fast-growing area of health care draws on the traditional clinical skills of a nurse or therapist with the technical skills of a computer whiz.

The field of health-care information technology (IT) is fueled by the industry's move to digital. Hospitals and physician practices are swapping out traditional paper charts for computerized medical records. States are launching electronic health information exchanges that allow doctors and other medical workers to seamlessly share information.

The Department of Labor expects that health care will add 50,000 jobs as the industry converts to digital medical records. To respond to this expected job demand, the federal government is funding $116 million in workforce training grants to community colleges and graduate-level programs.

In Arizona, hospitals have beefed up their health-care IT staffs. Some larger physicians practices have hired their own IT workers, and smaller and medium-size practices often rely on consultants or software vendors to establish and maintain electronic records.

"Generally, there is job growth in this area," says Melissa Rutala, CEO of Arizona Health-e Connection, a Phoenix-based non-profit that helps support medical practices converting to electronic records.

Gateway Community College received a federal grant to cover tuition costs for qualified students who are interested in the field. So far, the college has enrolled 225 students in six certificate programs through the Management of Clinical Information Technology program. The program takes about four months to complete, or sooner if the student takes on an aggressive timetable.

Although the college no longer has grant funds available to cover tuition costs, students still can enroll in the program. They are required to have six months' experience in either health care or information technology to be accepted to the program.

The six clinical IT programs are consulting, implementation support, technical support, technology training, implementation management and workflow/management redesign.

Heidi Hutchins, director of the Management of Clinical Information Technology program at Gateway, says the program initially attracted batches of laid-off IT workers during the worst days of the recession.

As the economy has gradually improved, more health-care workers are enrolling so they can add skills, earn a promotion or search for a new job.

"Most of the high-skilled IT folks have found other jobs," Hutchins says. "A lot of the folks we are seeing (enroll in the program) are working in health care."

About two out of three students who finished Gateway's certificate program have found a job in the field, according to Jay Covell, the program's grant manager. Other certificate graduates have not found an IT-related job, did not look for such a position or did not complete a survey mailed to them.

Covell says some recent graduates with little experience are struggling to find positions. Some employers are looking for workers with at least three years of experience.

"It makes it a little difficult for people who are acquiring these skills and are trying to get a foot in their new field," Covell says.

Banner Health, Arizona's largest hospital system, has hired about 60 health-care IT workers over the past year. Banner Health is recruiting both its own clinical workers who are interested in learning about IT as well as people from outside the organization.

Tina Angle, a recruiter for Banner Health, said that some nurses, physical therapists and other clinical workers have converted to IT jobs. Angle said that health-care workers generally respond better to a former clinical worker who is trained in IT than someone who solely has an IT background.

Former nurses and clinical workers can talk the medical lingo and understand how doctors and nurses do their jobs.

"IT people have changed over time," Angle says. "They are no longer the geek with the pocket protector. They are almost sales people. They really have to interact with physicians and the clinical side of the house."

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