The scope of work and practice authority for nurse practitioners (NPs) varies widely across the United States. In some areas, NPs are restricted from prescribing medication or can practice only under the supervision of a physician. In other states, like Oregon, an NP enjoys full practice authority, including as a primary care provider. They can evaluate patients, diagnose, order tests, manage treatments, and prescribe medications.
On the surface, Oregon’s laws and regulations seem to position NPs for an essential role in primary care. Yet, research released by the Oregon Center for Nursing (OCN) shows that only 25 percent of the state's NPs actually fill the role.
Facing a Primary Care Provider Shortage
“This is a good news, bad news story,” reflected OCN’s Executive Director, Jana Bitton. “On the positive side, our study illuminates how very versatile nurse practitioners are. Employers and organizations are recognizing the many different roles nurse practitioners can play. On the negative side, a nurse practitioner, educated and qualified to be a primary care provider, might take advantage of other opportunities.”
OCN’s study comes at a time when expanded access to primary care is a topic of conversation at a national and state level. Many advocates see nurse practitioners as a solution to the nationwide primary care physician shortage.
But, Bitton warns, “Before Oregon’s policymakers start relying on nurse practitioners to fill the primary care gap. We need to understand why so few nurse practitioners are currently practicing as a primary care provider.”
Researching Oregon's Primary Care Workforce
While anecdotal evidence exists about why practitioners avoid primary care, more research is required. “Unless there is a focused effort to incentivize NPs to bring their skills and talents to primary care settings throughout the state, patients and communities are at risk of being underserved in years to come,” says Bitton.
The full report, Primary Care Workforce Crisis Looming In Oregon, is available to download for free on OCN’s website.
