A pre-season (ie pre-re-awakening of HDP Blog) example!

Each day, between now and "opening day" for this health disparities blog, I hope to provide examples of why our organization decided there was a pressing need for it's August 22/23 MLKjr Health Equity Summit and a continuing educational effort through each year between subsequent Summits. The health policy blog is envisioned as a potentially useful venue to keep abreast of this complex and ever-changing societal effort to reduce health disparities. Illustrative examples are a good tool to appreciate why we think this is true.
Today's example has to do with the pressing need to address the issue of growing and perhaps reshaping the health care workforce over the coming decade if we are to have any reasonable chance of delivering excellent and cost effective health care to over 32 million currently unisured citizens. In the Jan. 20, 2011 issue of the New England Journal of Medicine, the editors published a cluster of short reports dealing with nursing education and practice. The first article, entitled "broadening the Scope of NursinG Practice"' by J A Fairman and others, summarizes the evidence that Advanced Practice Nurses, working indepently or in teams with physicians and other health professionals, can provide excellent primary care in a significantly cost-effective manner. After describing the traditional obstacles to such an expansion of nurse practice and pointing out that already 17 states allow such independent practice by qualified nurses, they conclude as follows, "Fighting the expansion of nurse practitioners' scope of practice is no longer a defensible strategy. The challenge will be for all health care professionals to embrace these changes and come together to improve US health care."
A major new Institute of Medicicine report provides a major foundation for the evidence and opinions above. One policy implication here is that the 33 remaing states which do not allow independent practice for nurses, should address that issue. But, there remains the question that there remains a dramatic nursing shortage in the USA.
A second relevant article in the same issue of the NEJM, "Nurses for the Future" by Linda Aiken, addresses that complex problem of an insufficienr supply cominG from the nursing educational pipeline. Dr.Aiken cites the impressive expansion in recent year of so-called retail clinics, staffed primarily by APRNs and that the supply os newly- minted APRNs is insufficienr to meet the anticipated demands. AIken argues that by shifting all nurse preparation program to the baccalaureate level via collaborative efforts involving community colleges and baccalaureate level institutions, tahr problems of nurse shortfal can be met. She argues that " public funding for nursing education must be used to steer the change in basic nursing education, just as public funding for patient care steers change in health care delivery." she goes on to identify existing educational public funding that can be used to address these changes. Aiken's ideas open up an area of innovative thinking about one of the most important issues (ie how to expand the health workforce) facing us right now and suggests to that there are certain workforce data that should be added to our growing list of evaluative benchmarks to check on as we follow progress in reducing health disparities over the coming decade.