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Open Letter to the American Medical Association

Dear Drs. Bailey and Madara,

On behalf of the nation’s 290,000 nurse practitioners (NPs) and the patients they serve, the American Association of Nurse Practitioners® (AANP) calls upon the American Medical Association (AMA) to cease its disingenuous attacks on the NP profession.

During a global pandemic, while NPs and physicians are working diligently each day to care for millions of American patients sickened, hospitalized — and in the worst cases — dying from COVID-19, your association has chosen to focus its energies on an offensive campaign designed to alarm and misinform the public and policymakers. This strategy is out of touch with the facts and the real challenges faced by our nation’s health care system.

For decades before the pandemic, NPs have met patient care needs by diagnosing, prescribing and managing patient care. NPs consistently deliver the high-quality, compassionate care they are educated, clinically trained and nationally certified to provide — health care services authorized by state law. In 22 states, the District of Columbia, two U.S. territories, the Veterans Hospital Administration and the Indian Health Service, NPs are authorized to directly provide these services. In the remaining jurisdictions, outdated regulations that the AMA continues to defend and advocate for needlessly bottleneck health care access by making it illegal for patients to access NP-delivered health care services outside an antiquated, bureaucratic contract with a physician. This outdated regulation needlessly creates geographic maldistribution of health care access, delays care and decreases the productivity of both NPs and physicians. In fact, just this week, research published in JAMA affirms NPs’ contributions to expanding access to care where it’s needed most. While AMA may prefer to ignore the facts, science and the needs of 80 million patients living in Health Provider Shortage Areas, NPs continue to deliver the care patients want and our nation needs in more than 1 billion patient visits each year.

The quality of NP-delivered care is irrefutable, affirmed by more than 200 studies that attest to the outstanding outcomes NPs deliver. NPs have a more than 50-year proven track record of delivering high-quality, affordable, patient-centered care. Patients receiving NP care have high satisfaction rates, shorter hospital stays, fewer avoidable emergency room visits and hospital readmissions and lower medication costs — not to mention significantly lower malpractice rates than their physician counterparts. Perhaps this is why so many physicians seek to hire NPs to join them in practice. Today, 80% of adults report they’ve been treated or know someone who has been treated by an NP, and more than 56% of patients report that NPs spend more time listening to them and addressing their concerns than other providers.

NPs and physicians should be working together to expand access to care and to meet the needs of patients. AANP will continue focusing its efforts on making care more available to patients, providing added choice and modernizing outdated laws that hinder effective and efficient health care delivery. We have no interest in playing gotcha games on Twitter; we’re committed to saving lives and building a health care system that works for patients and providers alike. AANP invites the AMA to step into the realities of the 21st century, respect the contributions and autonomy of other professions and partner with us as we rise to meet America’s health care challenges.


President, The American Association of Nurse Practitioners

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