A New Strawman: Why Nurse Practitioners Are Pivotal in Health Equity Work

Health equity is the new strawman argument. This article has been floating around social media recently. The article title initially drew my attention because of some key words that seemed to be strategically placed: nurse practitioners (NPs), pivotal, health equity. At first glance, it seems somewhat noble. I mean, who doesn’t want health equity. But then the article quickly turns to the rhetoric of full practice authority: “Nurse practitioners have the tools to be instrumental in health equity work, but need regulatory support to utilize those tools.” The words regulatory support are code for legislating FPA instead of higher education. The article plays on our sensibilities by describing health equity details that are designed to emotionally hook readers. A play on emotional issues often elicits blind emotional support. In this case, the article attempts to draw you in and hook you into supporting the FPA movement. Here it is:­­­  Nurse practitioners and those working within the AANP specifically have been sounding the alarm on healthcare disparities for years.  This quote is from the infamous Sophia Thomas, DNP, APRN, FNP-BC, PPCNP-BC, FNAP, FAANP, the president of the American Association of Nurse Practitioners (AANP). This is the article setting you up for ‘NPs to the rescue,’ in health equity, and the only way to do it is with FPA. “It’s nurse practitioners who can play a pivotal role.” The implied thinking is to make the leap that only FPA for NPs will solve health equities. “Importantly, Thomas said nurse practitioners need expanded scope of practice regulations in order to fulfill their potential while treating patients.” Health equity has become the new strawman argument. Although this doesn’t stop the article from bringing up another strawman argument about practice in rural areas, a lie that has been debunked: “There are 77 million Americans that live in communities that don’t have adequate access to primary health care, and about 80 percent of rural America is actually designated as medically underserved.” 

Thomas and the article seem to imply that only NPs and not physicians provide holistic care. This is nonsense. Medical education is holistic which is something NP Thomas doesn’t get. Another strawman. I mention this, because quotes in the article perpetuate this lie:

“So when we, for example, tell a patient she has diabetes and give her a prescription for her medication, we’re not just prescribing medication and saying ‘follow up with us in three months.’ We’re making sure that she can afford that medication. We’re discussing with her at that time some diet and lifestyle changes.”

“Nurse practitioners have the skills needed to begin work on health equity. These medical professionals, known for their holistic approach to medicine and positive rapport with patients, will be instrumental for an industry looking to address the social factors that limit access to care for traditionally marginalized populations.”

So all-in-all, this article brings up 5 rhetoric points which are being used as strawman arguments for the FPA movement:

  1. Health equity
  2. Rural practice
  3. Holistic care
  4. Limited access to care
  5. Fulfill their potential (i.e. top of their license, full extent of education and training)

I’m not anti-NP, I use to be one, but the lies and rhetoric needs to stop. 

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Robert Duprey MD

Robert is a 2nd career physician (MD); a combat Veteran with the US Army; a former psychiatric nurse practitioner; an independent researcher; a medical writer; and now having passed USMLE Steps 1, 2CK, 2CS, and 3, is a residency applicant.

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6 Responses

  1. Joseph says:

    Great article! I totally agree that nurse practitioners are essential part in improving public health sector.

  2. Jesse Belville,PA-C says:

    But no plans to refute the NP’s,organize your state and go after them politically to stop it..
    NO GUTS NO GLORY.. Are you going to get off your butts to stop this?
    I Cannot I am a PA-C. I chose to Always be #2 with a supervising MD/DO. Always learning,improving skills,helping my Doc, better serve his patients.. My how times change.
    We may all be Supervised by PHD nurses.. Welcome to your bright future…

  3. Gary Pearce says:

    Guys, so many of us want to live under the big lights. There is definitely a problem with distribution of health care resources. How do we force equitable distribution?
    Let’s just have the government take over. Like they have done with Covid……..
    This whole NP promise of rural services is garbage….as an ophthalmologist I have constantly heard that optometrists need to be able to provide the same level of services as my specialty because so often patients can simply not get to an ophthalmologist. It is a great scam and many legislatures fall for it. The premise is that we are all equal and it is unfair to patients to have to find the ophthalmologist. It will be exactly the same with NP’s. Some people just don’t know what they don’t know………..and if that is the state of your ‘doctor”, good luck to you as a patient!

    • Gary Pearce says:

      and I love the use of the word “holistic”……it is something chiropractors use along with nutritionists and anybody that sells snake oil!
      If you have to brag that you are holistic, then we have a problem!

  4. PW says:

    Let’s be real. While it may sound noble to say NPs will pick up the mantle of caring for the poor and minorities, realistically, they will do no different than many docs and when the going gets tough, pick up and do something more lucrative. And, if you’re saying that you want equity, why should someone in a needy community have to settle for a less trained practitioner?

    • Rick says:

      Great point, PW. I remember when I graduated way back when, we had a huge class, because the GOVERNMENT discerned a shortage in rural America. Guess what? Nobody went rural. We just filled up the big cities.
      Whenever the GOVERNMENT has an idea, do the opposite.

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