Learn about the Family Nurse Practitioner (FNP) scope of practice and how that has evolved in recent years, as the demand for primary and preventive care grows.

Recent research from the Association of American Medical Colleges (AAMC) found that, in this country, we will lack between 37,800 and 124,000 physicians by the year 2034. These numbers encompass primary care and specialty care physicians.

When Americans face limits to treatment access, wellness appointments are put off, thereby diminishing overall personal health. This ultimately makes urgent medical visits more possible and frequent, and thus exacerbates an increasing problem in the U.S: the demand for care is outpacing availability. If only America’s healthcare system could address this challenge with an existing solution.

Let’s now consider the Family Nurse Practitioner, or FNP, who is a type of advanced practice registered nurse (APRN). FNPs work with adults, children, women, and others across the lifespan, evaluating both normal and complex health cases. They often serve as primary care practitioners and help to meet the increasing need for quality, preventive healthcare. FNPs are required to obtain a master’s degree from an accredited institution. In an FNP-APRN program, students train through a robust curriculum and over 600 hours of hands-on, clinical experience so that they are prepared to practice.

What are some of the distinctions between physicians and FNPs? What makes the FNP scope of practice different from a physician’s work with the same patients? We’ve reviewed the latest on hot-button topics around the FNP scope of practice today.

Physician vs. FNP Scope of Practice Overview

Salary and time spent in school are what set physicians and APRNs apart. Both FNPs and physicians enjoy autonomy in the workplace as well as a competitive salary. According to the Bureau of Labor Statistics, APRNs made an average of $123,780 per year in 2021. Most relevant to our conversation about FNPs, pediatricians make $198,420 annually, and family and general practitioners make $235,930 per year. It’s clear that physicians are one of the best-paid job pathways in the country.

However, the bad news is that the physician job is growing at only a 3% rate, or slower than average, between 2020 and 2030. The good news? APRN job growth is trending at a 45% growth rate between 2020 and 2030, or much faster than average, to meet an approximate 29,400 openings annually over the decade.

One can make many inferences into the practical reasons for both trends. Perhaps financing the cost of a Doctorate is not possible for many students today. Maybe the required time in school and a residency, which can be up to nine years, is too great. APRNs can obtain their education in much less time—as few as 27 months! The time that it takes to graduate from student to professional is particularly relevant when we’re discussing a decade’s worth of distress from a shortage of medical workers. Some may find that a happy balance between their professional career and personal life is better obtained by becoming an APRN as opposed to a physician. This is where our discussion of the FNP scope of practice gets interesting.

The National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division (HMD) along with the Federal Trade Commission (FTC), and the Veteran’s Health Administration (VHA), among others, have a solution in mind. They recognize that the scope of practice for FNPs is so robust that they should be able to use their education and training to meet many patients’ needs currently unduly restricted to treatment by physicians. Furthermore, withholding their skills and qualifications from individuals in need of health care treatment is a travesty, especially when so many people have difficulty obtaining access to qualified care. The initiative to allow APRNs to practice all of their skills is called Full Practice Authority (FPA). Professional groups such as the American Nurses Association (ANA) are attempting to promote FPA across state laws to ensure that APRNs, such as FNPs, are not unfairly limited in their scope of practice.

The FNP Scope of Practice

Scope of practice concerns a healthcare provider’s ability to deploy their healing skills on patients and to achieve the best possible outcome, within their social contract and obligation to standards of practice. One of the challenges that the ANA and other FPA advocates meet is that each state governs the scope of practice rules individually. It is important to research what is included or omitted, from the current FNP scope of practice in the state in which you plan to practice.

FNPs typically carry out job duties such as:

• Conducting physical examinations, implementing diagnostic tests, and making diagnoses.
• Reviewing patient records and recommending and prescribing medication as necessary.
• Educating patients and their families about preventive care measures.
• Maintaining a contemporary understanding of medical research, publications, new technologies, pharmacology, and treatments.
• Understand population health concepts to bolster treatment of diverse populations (for example inmates, LGBTQ+ people, complex cases).

How does the job of a physician differ from an APRN, specifically an FNP? In 23 states and Washington D.C., APRNs can diagnose, treat, and prescribe medications. However, in the other 28 states, APRNs require physician oversight when prescribing medications. Physicians supply specialty care that requires an even deeper medical understanding than that which is achieved through APRN training.

It is the APRN’s job to manage the implications and impacts of an illness on the person’s health, while physicians focus on treating the specific illness. There is undoubtedly a symbiosis between physicians and APRNs.

Connecticut is a good example of this. According to the state’s official website, APRNs must practice “in collaboration with” a licensed physician for their first three years in the field (after obtaining an FNP license). They may collaborate on prescription medications, laboratory tests, diagnostic procedures, and other components of a patient’s treatment plan. After three years (two thousand hours) alongside a licensed physician, an APRN may then perform acts of diagnosis and treatment independently. This includes prescribing, dispensing, and administering medications and corrective measures.

For more information about becoming an FNP, or how you can inspire health in patients, and build a rewarding career for yourself, do not hesitate to reach out. Learn about Goodwin University’s efficient year-round FNP program online! Or, call us today with any questions at 800-889-3282.