Recognizing nursing's independent license: prescriptive authority for APNs.

A landmark study, published in the Yale Journal on Regulation by Yale Law School Dean Barbara J. Safriet, addresses the cost effectiveness and quality of advanced practice nurses: "Since the productivity of [APNs] has been demonstrated by the fact that they can provide equal care for a full range of health services traditionally provided by physicians, and since their training costs and employment costs are substantially less than those of physicians, it appears indisputable that they are truly cost-effective health care providers. This cost effectiveness, combined with their proven ability to provide quality care to a large number of people, suggests that they should play a central role in the solutions currently being developed for our health care crisis. Despite their proven and potential contributions, however, several unnecessary barriers stand in the way of their full utilization.... Chief among these are conflicting and restrictive state provisions governing the scope of practice and prescriptive authority of [APNs].... As a result of these provisions, [APNs] are severely hampered--or disabled altogether--in their efforts to fulfill their fully proven potential to enhance our nation's health.... Prescriptive authority is central to APNs' effective practice.... States that limit APNs to a physician-dependent scope of practice, including prescriptive authority, actively impede the public's access to safe and effective health care."