This week, Florida TaxWatch (FTW) released “Physician Shortages: Better Utilization of Advanced Practice Registered Nurses in Palliative Medicine Could Provide Relief,” a briefing explaining how fully utilizing the advanced practice registered nurse (APRN) workforce has the potential to significantly mitigate the existing physician shortage and similar issues that may arise in the future, particularly in palliative care and hospice facilities.
Florida TaxWatch President and CEO Dominic Calabro weighed in on the findings.
“The nation’s population is growing quickly, and in Florida, where nearly 1,000 people are moving here every day, over 20 percent of the population is 65 years of age or older. The current physician shortage is impacting patients of all ages, but given Florida’s significant concentration of seniors, it’s particularly problematic for those in palliative care or hospice facilities,” Calabro said. “Palliative care and hospice physicians are facing demanding caseloads, leading to burnout and ultimately preventing them from providing their patients – people with chronic illnesses or at the end stages of life – the quality care they both need and deserve. In fact, on a national level, more than 30 percent of palliative care physicians reported experiencing burnout in their positions.
“Giving proper autonomy to advanced practice registered nurses, or APRNs, and allowing them to attend to patients with their advanced professional expertise would alleviate some of this stress felt by physicians in palliative care and hospice settings. However, in Florida, that can only be accomplished by amending state law, specifically the Autonomous Practice Act, to extend to this important medical specialty,” he added. “Florida TaxWatch encourages the Florida Legislature to consider this solution, especially as the APRN workforce continues to experience substantial and consistent growth and professional development. It is safe, as all APRNs must complete extensive education and relevant training. It is also cost-effective, given APRNs’ wages relative to physicians, and most importantly, it is in the best interests of palliative care and hospice patients.”
In Florida, physician demand is projected to exceed supply by at least 20 percent in nearly every Medicaid region by 2035. Similarly, there is expected to be a statewide physician shortage of 18,000 by 2035. Palliative care and hospice physicians, in particular, are and will remain in high demand given the state is home to nearly five million Baby Boomers – the generation between 59 and 77 years of age – who will require more specialized medical attention in the years to come. Additionally, the number of Americans living with chronic illnesses has increased over time, now estimated to be six in every 10 adults.
However, according to the FTW briefing, while the number of patients eligible to receive palliative care is expected to grow by 20 percent over the next 20 years, there is only a one percent projected growth in palliative care physicians.
FTW strongly recommended extending the Autonomous Practice Act (Section 464.0123 (3), Florida Statutes) to APRNs, enabling them to perform largely administrative, yet essential tasks in palliative care and hospice facilities, in addition to primary care facilities. This is best for patients because:
The APRN workforce is expanding;
Utilizing nurse practitioners is associated with lower costs and high quality of care; and
The education and training of APRNs fully prepares them to perform these tasks.
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