Senate Bill 2 should enhance heath care access, effectiveness

To the Editor,Last year, the Michigan Senate passed Senate Bill 2 defining the role of Advanced Practice Registered Nurses (APRNs) in the Public Health Code. As a physician in practice for over 30 years, I feel strongly that it is time for the Michigan House to follow suit. In order to bring the bill to a vote in the full House, Rep. Gail Haines first needs to allow the bill to be voted out of the Health Policy Committee, which she chairs. The issue has been examined and discussed thoroughly in the Senate and then in a House Health Policy Committee hearing in September. No further deliberation is necessary. The safety, quality, and cost effectiveness of APRN practice has been demonstrated by over 40 years of research, and by the positive outcomes in other states that currently allow APRNs to practice to the full extent of their education, experience, and licensure.The Michigan State Medical Society (MSMS), representing fewer than half of Michigan physicians, historically has opposed any perceived encroachment on the turf of physicians by any other providers. Their position flies in the face of recommendations of the Institute of Medicine and other highly regarded national experts. In a recent op-ed, the president of MSMS also suggests that SB 2 would somehow work against care being provided by a team of providers. There is no evidence to show that this has occurred in the 19 other states that have passed similar legislation. All health care providers have an obligation to work in partnership with others for the benefit of the patient. In my experience, APRNs, by virtue of their nursing education and philosophy of care, consistently promote a team model of care and can be expected to continue this.MSMS spokesmen also demean APRNs by implying that their educational level is inadequate. APRNs practice safely within their role and scope, and refer to physicians or other providers as needed. Years of research have shown that the education of APRNs prepares them effectively. No one denies that physicians with many extra years of specialized training have an important role to play in complex and difficult cases. The bottom line is that Senate Bill 2 should enhance both access to care and cost effectiveness. Licensure, and board certification (based on national standards) is in place for both physicians and APRNs as a protection for the consumer. Michigan is facing a serious physician shortage. The health care environment is changing rapidly. The Michigan Public Health Code must be updated now so that Michigan is prepared to meet the needs of patients. Daniel G. McMurtrie, M.D.Chair, Department of Obstetrics and GynecologySt. Joseph Mercy Hospital Ann Arbor