When Medicare and Medicaid expanded in the 1960s, nurse practitioners emerged to help meet the increased demand for primary care services not met by the then-available physician work force. Similarly today, increased demand for primary and preventive care services under the Affordable Care Act (ACA) will mean that an additional 16 million people will seek health care by 2016. Our aging population means increased demand for chronic disease management services. By 2019, the demand for primary care will require 4,000 to 7,000 more physicians to maintain the level of current service. Nurse practitioners, physician assistants, advanced practice nurses (APNs), certified nurse anesthetists and doctors of nursing practice, who are sometimes referred to as “physician extenders” or “mid-level providers,” are filling this health-care gap. There are 192,000 nurse practitioners in the United States and this number is increasing by 14,000 each year.
New Jersey issues professional licenses for APNs in a variety of specialties, from anesthesiology to heart failure, and which allow them to provide care under regulations designed to increase patient care while preserving patient safety. Although they have less medical training than medical doctors, they undergo a rigorous educational and licensing process. States are increasing scope of practice laws so nurse practitioners and other physician extenders help meet this demand. However, expanding the scope of practice for nurse practitioners also expands malpractice liability. The responsibility for negligent patient injury includes not only the new nurse practitioners but also the physicians, offices and hospitals who employ them.
Regulations Governing Advanced Practice Nursing
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