The United States has been on the edge of an encroaching physician shortage in primary care. As graduating physicians are choosing to specialize in lucrative fields such as cardiology or neurology, the family practice office gathers dust. At the same time, an aging population is creating a need for more providers than ever to be available for routine check-ups and minor illnesses.
Utah is not different. In fact, Utah’s shortage of physicians is worse than the national average. The legislature has just taken an important step towards addressing this challenge.
With the recent passage of SB36, Utah may soon allow nurse practitioners to prescribe all schedules of medication. The bill was passed in both the Senate and the House, and is now awaiting the signature of Gov. Spencer Cox.
This was a long process, as the original expansion began with HB287 in the 2021 legislative session. A lack of clarity on rules relating to medication provisions, however, has prevented nurse practitioners from full job autonomy. SB36 clarifies this language and fully empowers nurse practitioners to serve all the needs of Utah patients.
Nurse practitioners are highly trained medical providers. Unlike a registered nurse or licensed practical nurse, nurse practitioners are a type of advanced practice registered nurses with significant post-baccalaureate training. Many nurse practitioners complete a doctorate in nursing practice. Popularly called the DNP, this degree is the highest form of educational training in the nursing profession and includes courses on pharmacology, population health and an extensive number of supervised clinical hours.
Utah will not be unique if nurse practitioners are permitted to work to the full extent of their training. Twenty-six states and D.C. have addressed this issue of reduced access to primary health care providers by giving full autonomy to nurse practitioners so that they may perform the functions of their jobs such as diagnosing and referring patients, prescribing medication and developing treatment plans, without the need for direct supervision by a physician. The reason for this is simple: Nurse practitioners provide high-quality care and an overwhelming majority of them remain in family practice, internal medicine, or other forms of primary care.
So, what does this mean for Utah? Quite a few things: Not only may it be easier to set office visits, nurse practitioners are also more likely to start practices in underserved or rural communities. This is important, as Utah has 55 cities and counties that are designated as health provider shortage areas for primary care in 2023. Nurse practitioners are reimbursed at 85 percent the rate of a physician to Medicare, which may lead to cost savings for retirees and people with disabilities that are enrolled as Medicare beneficiaries.
If SB36 becomes law, both nurse practitioners and physician assistants will be empowered to provide health care in the Beehive State. More work remains, however, as many other options for expanding health care access are currently not lawful. While being in the top-five states in births per capita, Utah does not allow certified midwives to prescribe medication without physician supervisions, even when working with patients for months through primary care and during the entire process of labor and delivery.
Utah also restricts the practice authority of pharmacists, psychologists, dental hygienists and many other professions that could improve health care professional shortage areas where access to primary care, dental care and mental health resources are lagging behind that of neighboring states.
Here’s hoping that SB36 is the first of many more actions to help increase the supply of health providers in the state. Let’s make sure that the hands of skilled workers are not tied by unnecessary and outdated regulations.
Alicia Plemmons | West Virginia University
Alicia Plemmons, Ph.D., is a research fellow and coordinator of scope of practice research at the Knee Center for the Study of Occupational Regulation at West Virginia University.