September 21, 2015

Joseph T. Mills

5007 SW 1^st Avenue

Ocala, FL 34471

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Editor Brad Rogers

2121 SW 19^th Avenue Road

Ocala, FL 34471

Dear Mr. Rogers,

I am writing to bring to the attention of your subscribers, the future loss of primary and family care to our community. The Association of American Medical Colleges (AAMC) estimates that in the United States (U.S.) over the next five years there will be a shortage of over 20,000 family practice and primary care physicians. The U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), estimates a 29% shortage in registered nurses over the same period of time. With the ever increasing population and changes in health care reimbursements, the availability and access to primary and family care will be severely compromised. I am speaking of routine wellness care, minor sickness and injury care, children, women’s and elder care. These are the services that keep the greater part of our community out of the acute care setting, like emergency departments and hospitals. This is the area of medicine that concentrates on keeping the community healthy, keeping the costly burden of secondary care down. 

As a local nurse working in this area for thirty plus years, no one is more aware or concerned for the coming shortages than I am. One of the remedies for our coming challenge, would be to allow nurse practitioners a more dynamic and independent role. Their history of outstanding performance and service in these roles has exemplified their successful ability to fulfill these shortages (Institute of Medicine, 2011). With the demand growing and availability of physicians falling, it would seem the wisest and most cost effective solution. Twenty one states and the District of Columbia have adopted this path yet, Florida has not. It would seem that our elected representatives have a differing agenda. The safety of Advanced Practice Nurses (APN) has been rigorously studied with decades of data to show no discernible difference in patient outcomes between physicians and nurse practitioners (Mullinix & Bucholtz, 2009). So, why do they allow bills to die, such as the recent bill CS/HB 547, extending the scope of practice for ADN’s and Physician Assistants (PA’s), which had a House approval vote of 75%? I have to assume our representatives are not hearing the voices of their constituents.  

So, my intention for this letter is to reach out to our community. I ask that they become proactive in making their voices heard in support of allowing nurse practitioners to operate independently from physicians here in Florida like the 21 other forward looking states. The literature and data is out there in support of these changes. We merely need to let our representative know, it is there elected duty to act on our behalf and pass these laws to enable a safe future for our community. If each person would call or write their local Representative voicing their concern and support for these bills, favoring the independence of Advanced Practice Nurses, our future health care will be there to take care of us.

Sincerely, 

Joseph Mills, RN, CCRN 

Enclosure (1)

References  

Association of American Medical Colleges (AAMC). (2014, March) Association of American Medical Colleges. Retrieved from           http://www.aamc.org/download/426260/data/physiciansupplyanddemandthrough2025keyfindings.pdf 

U.S. Department of Health and Human Services, Health Resource and Services Administration. (2002, July). HRSA Report on Registered Nurse Supply and Demand. Retrieved from http://www.ahcancal.org/research_data/staffing/documents/registered_nurse_supply_demand.pdf 

U.S. Department of Health and Human Services, Health Resource and Services Administration. (2014). HRSA Report on Primary Care Supply and Demand. Retrieved from http://bhpr.hrsa.gov/healthworkforce/supplydemand/usworkforce/primarycare/ 

Institute of Medicine. (2011, February 17). Institute of Medicine Report- The future of Nursing: Leading Change, Advancing Health. Retrieved from http://www.policymed.com/2011/02/institute-of-medicne-report-the-future-of-nursing-leading-change-advancing-health-.html 

Mullinix, C., & Bucholtz, D.P. (2009). Role and quality of nurse practitioner practice: A policy issue. In D.J. Mason, S.L. Isaacs, & D.C. Colby, The Nursing Profession: Development, Challenges, and Opportunities (pp. 198-205). San Francisco, CA: Jossey-Bass.