The 2011 Institute of Medicine (IOM) report “Future of Nursing: Leading Change, Advancing Health” pointed out that because nursing scope of practice regulations vary across states, and because there is little rationale for these variations, the federal government, through the Federal Trade Commission (FTC) and the Antitrust Division of the Department of Justice, “is well situated to promote effective reforms [related to regulation of APRN scope of practice] by collecting and disseminating best practices from across the country and incentivizing their adoption.”
The IOM recommended that the FTC and the Department
of Justice review existing and proposed state regulations related to advanced
practice registered nurses (APRNs) to identify those that limit competition
without contributing to the health and safety of the public, and urge such
states to allow APRNs to provide care to patients in all circumstances in which
they are qualified to do so.
Created in 1914 to promote consumer protection by eliminating
and preventing anticompetitive, unsafe, or deceptive business practices, the
FTC is the logical agency to address scope of practice laws. The FTC’s
responsibility is to promote competition,
inform consumer choice, and protect consumer safety. All are directly related
to APRN scope of practice regulations, including those mandating physician
supervision and oversight of APRNs when there is not “a compelling consumer
protection rationale” for doing so. That includes evidence justifying
restrictions on APRNs’ ability to provide health care services that could
override the public interests with regard to choice, cost or competition.
