New York State NPs DO PRACTICE IN RURAL & HEALTHCARE SHORTAGE AREAS!

A common critique of the Nurse Practitioner (NP) profession is that in states that have Full Practice Authority (FPA) or near FPA, NPs do not go into rural or healthcare shortage areas.?

Here is some evidence, which is not recent by any means, that is frequently used in an attempt to generalize the reality of NP practice nationwide. Please know that the delivery of healthcare is different state to state, you cannot compare a state like Idaho (population of 1,981,332) versus New York (population of 20,215,751) for example. Needs are different, demographics are different.

"Sixteen states allow nurse practitioners to diagnose and prescribe without any physician collaboration. Four of those that feature metropolitan areas and large, rural areas like Texas are Idaho, Oregon, Arizona, and Utah. As is evident by the AMA practice distribution maps below, granting independent practice to nurse practitioners does not change their tendency to practice in metropolitan and suburban communities. According to a 2007 survey performed by Advance for Nurse Practitioners, of 6,162 respondents, 77% reported that they practiced in cities or suburbs, while only 23% practiced in a rural setting." (Primary Care Coalition, 2007).

The above is an excerpt from a 2007 report by the Primary Care Coalition, a physician organization (bias anyone?).

Here is another graphic I found on Reddit that is from the state of Arizona in 2013. This is almost a decade ago. In any research, unless it is a seminal work, evidence should be within 5 years of publication.

But is this the case in the State of New York?According to the Center for Health Workforce Studies (CHWS) within the School of Public Health at the University at Albany, State University of New York: THIS IS NOT THE CASE.

According to the Primary Care Development Corporation:

THIS IS NOT THE CASE.

"Most primary care providers in New York State are physicians followed by nurse practitioners. However, the numbers of NPs are greater in rural and small-town areas and notably higher in Health Professional Shortage Areas. This may be due to the introduction and success of loan forgiveness programs, which incentivize nurse practitioners to work underserved communities in exchange for educational funding." (Primary Care Development Corporation, 2021).

Citations:

Allard, A. Ford, M. Smith, AM. Summers, C. 2021. “Characteristics of Primary Care Providers in New York State.” Points on Care Data Brief 8. Primary Care Development Corporation. New York, NY.?

Stiegler K, Martiniano R, Harun N, Wang S, Forte G, Moore J.?A Profile of New York State’s Patient Care Nurse Practitioners. Rensselaer, NY: Center for Health Workforce Studies, School of Public Health, SUNY Albany; November 2021.?