Joint Statement on the Scope of Nurse Practitioners


November 12, 2020

Dear Drs. Bailey and Madara,

The American Association of Nurse Practitioners® (AANP), Gerontological Advanced Practice Nurses Association (GAPNA), National Association of Pediatric Nurse Practitioners (NAPNAP), National Association of Nurse Practitioners in Women’s Health (NPWH) and the National Organization of Nurse Practitioner Faculties (NONPF) issued the following statement regarding the American Medical Association’s (AMA) continuing harmful campaign of disinformation about the scope of nurse practitioner (NP) practice and the care NPs deliver:

As national organizations representing all NPs, the NP Roundtable calls on the AMA to cease its outlandish campaign of disinformation, “Stop Scope Creep,” and its continued efforts to insult and degrade the outstanding care delivered by NPs in more than 1 billion health care visits each year. Rather than forge a collegial relationship focused on patients’ access to care, improved health outcomes and health care provider well-being as our nation continues to battle a pandemic, the AMA has chosen to direct its resources to a misleading and malicious campaign. To further cause fractures within a healthcare system stretched to the brink by inciting unfounded patient fear and mistrust of advanced practice nurses is unconscionable. Now is the time to pull together, serving the public by recognizing and fully utilizing the strengths of each discipline.

Contrary to the AMA’s assertions, NPs consistently deliver high-quality, evidence-based health care that they are educated, clinically trained and nationally certified to provide — care that is authorized by state law. The scope of practice for NPs includes: assessing patients, ordering and interpreting diagnostic tests, making diagnoses and initiating and managing treatment plans — including prescribing medications. More than 50 years of patient outcomes and peer-reviewed clinical research have demonstrated that nurse practitioners consistently provide safe, high-quality, accessible, affordable health care.

The AMA knows that our nation faces a health care provider shortage fueled by the aging of baby boomers (including the retirement of physicians) and a decision by the vast majority of physicians to choose lucrative specialties over primary care practice. By 2030, it is estimated the nation will face shortages of more than 120,000 providers to address patient demand. These projections were created before the global pandemic we now face, with millions of patients sickened and dying of COVID-19.

By contrast, the overwhelming majority of NPs are prepared and practice in primary care. Our ranks are growing significantly as the public recognizes the value and service we provide. Nurse practitioners currently provide nearly one-fifth of all primary care services in the U.S. and represent the fastest growing segment of the primary care workforce. As new research published in the Journal of the American Medical Association shows, NPs are gravitating to areas where patients need them most, including rural and medically underserved areas. Yet, outdated state laws advocated for by the AMA are creating unnecessary barriers for NP practice — and most importantly — for patients seeking NP-delivered care.

In 22 states and the District of Columbia, patients have full and direct access to NPs, providing consumers a choice of heath care provider and strengthening patient access to primary care. This model of regulation is known as Full Practice Authority, and the states that have adopted it are seeing the direct benefit of growing provider workforces to increase patients’ access to safe, high quality, affordable health care. These states consistently rank highly in many quality and access measures of health care. In the remainder of states, outdated licensure laws reduce or restrict patients’ access to NPs, limiting access to care, increasing cost, and creating bottlenecks across our health system.

Amidst a global pandemic and a primary care access crisis, NPs are focused on our country’s needs, while instead, the AMA has chosen to sling insults and hashtags. We call on the AMA to stop misinforming the public and policymakers. We implore you to take a stand for diversity, equity, and inclusion among the health care professions, and to make a long overdue statement condemning public incivility, bullying, and harassment of nurse practitioners. Instead of clinging to outdated structures whose sole focus is to protect physicians from market competition, our organizations implore you to practice civility and rise with us to the challenge our nation faces. Join us in supporting Full Practice Authority – reflective of our scope and our outstanding record of patient outcomes. Our nation and our patients deserve nothing less.

The NP Roundtable is a collaborative of national NP organizations representing the interests of the over 290,000 NPs in the US. The NP Roundtable advances common policy agenda and coordinates advocacy efforts on behalf of NPs. Since its formation in 2008, the NP Roundtable has developed common position and policy statements to articulate the perspective of the NP community. The participating organizations in the NP Roundtable are the American Association of Nurse Practitioners, Gerontological Advanced Practice Nurses Association, National Association of Pediatric Nurse Practitioners, National Association of Nurse Practitioners in Women’s Health and the National Organization of Nurse Practitioner Faculties.

Download the Statement