The Public ’ s Interest
The rationale to remove the requirement for written NP-physician collaborative agreements is not to save money , although it will , but to improve access to needed primary care . In 2015 , the total number of graduates from U . S . medical schools electing primary care residencies was only 1,965 for the whole country , clearly not enough to offset physician retirements much less keep up with population needs . In contrast , 14,400 NPs graduated from primary care programs in the same year , and this number is increasing annually ( Pohl , Barksdale , & Werner , 2015 ).
Currently , 22 states and the District of Columbia do not require collaborative agreements for NP practice . The residents of these states have suffered no adverse outcomes , and access to primary care has increased . Required collaborative agreements limit the growth of the number of NPs available to provide care ( Reagan & Salsberry , 2013 ) and they deter NPs from locating in areas of greatest need where there are few physicians . In states that do not require collaborative agreements , NPs are significantly more likely to work in primary care ( Barnes , Maier , Altares Sarik , Germack , Aiken , & McHugh , 2016 ), and more patients in those states receive primary care from NPs ( Kuo , Loresto , Rounds , & Goodwin , 2013 ).
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There is no evidence that quality of care is diminished or patient safety is at risk with the elimination of collaborative agreements ( Fairman , Rowe , Hassmiller , & Shalala . 2011 ). Consistent with these findings , modernizing Pennsylvania ’ s laws will increase access to primary care for all residents ; help rural residents get timely care ; shorten appointment delays for Medicaid patients ; and enhance consumer choice of healthcare providers . Adoption by the Pennsylvania House of Representatives of SB 717 is in the public ’ s interest .
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