104 ■ I: HISTORICAL AND THEORETICAL FOUNDATIONS FOR ROLE DELINEATION
clearly noted why “residency” is not a good description of NP postgraduate orientation
into a new clinical practice.
An additional paper by Sheehan (2010) must not be forgotten because of the
importance of the Roundtables message in “The Value of Health Care Advocacy for
Nurse Practitioners.” We must remember that NPs do win some legislative battles and
lose some, but one success was getting language inserted into the Reconciliation Act,
allowing Health and Human Services (HHS) secretary to include NP leaders in medical
home demonstration projects.
The Coalition for Patients’ Rights (CPR) was established in 2006 for the sake of
giving patients a choice of providers and fighting barriers to quality care. As of 2016,
CPR consisted of more than 35 organizations of a variety of licensed health care pro-
fessionals who provide safe, effective, and affordable health care to millions of clients
each year (CPR, 2010a). CPR was formed to prevent SOPP from implementing unneces-
sary actions against allied health professionals that “will impede, rather than enhance”
(CPR, 2006, p. 1), patient access to evidence- based care by these nonphysician providers.
CPR also advocates for “the practice rights of its members for the sake of their patients”
(CPR, 2010b, p. 1). CPR seeks to have a balanced study of all health care providers’ edu-
cation, accreditation, certification, and licensure, and would like such a study to “assess
whether state laws and regulations governing physicians practice contain outdated lan-
guage that should be eliminated so that the unique skills of licensed healthcare profes-
sionals who do not hold a medical license are recognized” (CPR, 2006, p. 2).
In addition, such a study would “evaluate the implications of current state laws
that allow physicians to practice in any specialty, regardless of the individual qualifica-
tions to do so” (CPR, 2006, p. 2). Support statements from more than 35 organizations
can be found on CPR’s website, as well as from media resources. In December 2008,
the American Nurses Association (ANA, 2008) (a 2006 founding member of CPR) reaf-
firmed its support for patient access to licensed health care providers of their choice in
a press release stated:
Patients deserve to have access to the expert care that nurses can give them.
Doctors do not have the right to impede nurses merely because we threaten
their “territory.” We can do more to improve patient care by working together
rather than at odds with each other. (p. 1)
This statement by the ANA was made in concert with the aforementioned 35 other
national health care organizations to rally toward the “common cause of ensuring that
all patients have access to quality care” (CPR, 2010b, p. 1).
In 2015, CPR commended our colleagues at the American College of Cardiology
(ACC) regarding its 2015 ACC Health Policy Statement on Cardiovascular Team- Based
Care and the Role of Advanced Practice Providers. ACC stated, “team core leaders should
be flexible, reflecting the specific needs of the patient at a particular time and setting. A nurse
or pharmacist may lead a team that organizes a chronic anticoagulation clinic” (p. 1).
Each state’s professional society tracks the number of providers that a state has
and will need in the next 10 years. Sadly, the results of these studies document over
and over again the shortage of physician providers to provide primary care to the cli-
ents of a particular state. In fact, the American College of Physicians (ACP) released a
monograph in 2009, which stated, “NPs and physicians have common goals of provid-
ing high- quality, patient- centered care and improving the health status of those they
serve” (p. 1). Furthermore, the ACP recommended that any demonstration project of
the patient- centered medical home model should include one run by an NP (ACP, 2009).
This is a perfect position for a DNP- APRN- CNP. AMA still states that DNPs must prac-
tice under physician supervision as part of a medical team, but this is much less apt to