ACP urges caution on wider duties for nurses

While advanced practice nurses ought to have the authority to practice medicine to the fullest level of their training, that doesn't mean state lawmakers should change scope-of-practice rules so that patients wind up in the hands of caregivers with inadequate education, a physicians' group says.

The Philadelphia-based American College of Physicians, representing internal medicine specialists, said last month's sweeping report from the Institute of Medicine on the future role of nursing recommends changes that are at odds with the goals of delivering patient-centered and team-based healthcare. The ACP's response to the 586-page report came out Monday.

“Today, no one clinician should practice independently of other clinicians,” the physicians' group said. “The goal should be to develop collaborative and team-based models that allow every member of the team to contribute to the best possible outcomes to the full level of their training and skills while recognizing differences in their training and skills.”

The IOM said skilled nurses—who are quicker and easier to educate than doctors—should be allowed to take on more primary-care roles to meet the future demand under healthcare reform and the aging of the baby boomer population.

However, the ACP said workforce policies should be written to recognize that producing more skilled nurses and physicians assistants “does not eliminate the need or substitute for increasing the numbers of general internists and other physicians trained to provide primary care,” the group said in its response.