Up & Coming Weekly

May 16, 2023

Up and Coming Weekly is a weekly publication in Fayetteville, NC and Fort Bragg, NC area offering local news, views, arts, entertainment and community event and business information.

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4 UCW MAY 17 - 23, 2023 WWW.UPANDCOMINGWEEKLY.COM STAFF PUBLISHER Bill Bowman Bill@upandcomingweekly.com OPERATIONS DIRECTOR Paulette Naylor accounting@upandcomingweekly.com MANAGING EDITOR April Olsen editor@upandcomingweekly.com ASSISTANT EDITOR Hannah Lee assistanteditor@upandcomingweekly. com ART DIRECTOR Courtney Sapp-Scott art@upandcomingweekly.com GRAPHIC DESIGNER Isaiah Jones graphics@upandcomingweekly.com STAFF WRITERS Alyson Hansen Ashley Shirley Kathleen Ramsey Chayenne Burns Katrina Wilson Aubrette Reid CONTRIBUTING WRITERS John Hood, Rep. Richard Hudson, Keith Ranson, Jami McLaughlin, Ben Sessoms, Ashley Kelsey, Muriel Brooks MARKETING ASSOCIATE Linda McAlister linda@upandcomingweekly.com SALES ASSISTANT Sheila Barker salesassistant@upandcomingweekly. com COVER Design by Courtney Sapp-Scott Up & Coming Weekly www.upandcomingweekly.com 208 Rowan St. P.O. Box 53461 Fayetteville, NC 28305 PHONE: 910-484-6200- FAX: 910-484-9218 Up & Coming Weekly is a "Quality of Life" publication with local features, news and information on what's happening in and around the Fayetteville/Cumberland County community. Published weekly on Wednesdays, Up & Coming Weekly welcomes manuscripts, photographs and artwork for publication consideration, but assumes no responsibility for them. We cannot accept responsibility for the return of unsolicited manuscripts or material. Opinions expressed by contributors do not necessarily reflect the views of the publisher. The publisher reserves the right to edit or reject copy submitted for publication. Up & Coming Weekly is free of charge and distributed at indoor and outdoor locations throughout Fayetteville, Fort Bragg, Pope Army Airfield, Hope Mills and Spring Lake. Readers are limited to one copy per person. © 2020 by F&B Publications, Inc. All rights reserved. Reproduction or use of editorial or advertisements without permission is strictly prohibited. Various ads with art graphics designed with elements from: vecteezy.com and freepik.com. In North Carolina, Medicaid expansion is a foregone conclusion. e General Assembly approved the necessary legisla- tion. Gov. Roy Cooper signed it. While expansion is contingent on the passage of a state budget, no one doubts that'll hap- pen. So, the governor finally secured his highest legislative priority. Republican leaders got a few reforms of the certificate-of-need system, which will break up some of our state's medical monopolies. And hundreds of thousands of uninsured North Carolinians will be enrolled in a health plan for which they'll pay nothing. All gain, no pain? Of course not. Med- icaid expansion isn't "free." Every time a state says yes to federally financed expan- sion, America's federal budget gets further out of whack and America's taxpayers are plunged deeper into debt. And every time a state offers residents "free" health care, demand goes up — including in emer- gency departments — while the supply of medical facilities and professionals lags behind. at's why Phil Berger and other leaders of the North Carolina Senate included in their Medicaid-expansion plan several measures to expand supply. Cooper and the House gave a partial yes to one of them, CON reform. Unfortunately, they gave a flat no to another supply-side change: allowing advanced-practice nurses to operate more independently. e term of art here is "scope-of-prac- tice" reform. It allows nurses to provide the full array of services for which they are licensed without having a physician take a cut of their fees. Limiting the scope of nursing practice has the effect of raising prices and limiting services to patients, especially in sparsely populated or impov- erished areas where it may be uneconom- ical for doctors to set up shop. Advanced-practice nurses have gone beyond undergraduate degrees to obtain additional education and training. Some, nurse practi- tioners, provide generalized or family care. Others special- ize in a category of care, such as nurse midwives and nurse anesthetists. Physician organizations are, not surprisingly, skeptical if not openly hostile to scope- of-practice reform. While the prospect of losing revenue to advanced-practice nurses is one of their concerns, I've talked with enough doctors to know that many also sincerely believe patients with seri- ous conditions will be poorly served by nurses practicing on their own — that some patients will be misdiagnosed, provided incorrect or inadequate treatment, and perhaps even die as a result. is objection isn't a frivolous one. It deserves serious consideration. Because there's a significant variation in how states regulate the practice of nursing, however, this objection can be tested with real- world data. Do places where nurses are al- lowed to practice independently up to the level of their licenses exhibit higher rates of medical accidents, chronic disease, or mortality? In a paper just released by the National Bureau of Economic Research, Emory University scholars used two measures — malpractice awards and adverse action reports involving advanced-practice nurses — to look for harmful effects of scope-of-practice reform on medical outcomes. Here's what they found: states that have granted full practice authority to their nurses have seen no such increase in patient harms. Indeed, the economists concluded that "physicians may benefit from the law change in terms of reduced malpractice payouts against them." is is hardly the first study to reach a similar conclusion. Some years ago the National Governors Association published a comprehensive survey of peer-reviewed research on advanced- practice nursing. e studies generally found that nurse practitioners "provided at least equal quality of care to patients as compared to physicians," and in par- ticular that they "rate favorably in terms of achieving patients' compliance with recommendations, reductions in blood pressure and blood sugar, patient satisfac- tion, [and] longer consultations." If patients prefer to visit a physician, they should have every right to do so. But if they're comfortable with a nurse practitioner — and don't want to drive a long distance to wait at a doctor's office — shouldn't they also have that right? Scope-of-practice reform didn't make it into the Medicaid-expansion deal. But there's still plenty of time left in the 2023 legislative session to rectify that mistake. PUBLISHER'S PEN Give nurses more freedom to practice by JOHN HOOD Letters to the Editor Do YOU have something to say? We want YOU to be heard! We want EVERYONE to be able to voice their opinions on current community events. Let us be a place to start much needed conversations. ALL VOICES WELCOMED! EMAIL: editor@upandcomingweekly.com CALL: 910-484-6200 "Scope-of-practice" reform allows nurses to provide a full array of services for which they are licensed. JOHN HOOD, Board Member, John Locke Foundation. COMMENTS? Editor@upandcomingweekly.com. 910- 484-6200

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