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Unintended Consequences: When a well-meaning attempt packs an inappropriate punch

By Haley Hoy
Nurse Practitioner, Huntsville Hospital

Huntsville—”Nurse Practitioners at Huntsville Hospital are working hard to provide critical services in Huntsville and are appreciated for their continued contributions to the Hospital and to patients.”

These are the words of David Spillers, CEO of Huntsville Hospital System. Unfortunately, due to the wording of a recent publication, this was not message received by the hard-working professionals. The article’s intent, to showcase nurse practitioners and physician assistants as a potential part of the solution to the nationwide physician shortage, was lost in a discussion of the differences among the two.

While it is true there are differences in the training of nurse practitioners and physician assistants, neither has specifically a “greater range of skills” or is better trained. All 50 states utilize nurse practitioners and define them in their regulatory codes with over 25 states authorizing independent nurse practitioner practice.

Alabama, however, was recently ranked last in patient access to care related to “severely restrictive” nurse practitioner regulations. (

This is a time of healthcare crisis when non-physician providers of all types should be working together to impact regulatory restrictions that are affecting patient access to care. Miscommunications and misstatements serve to only confuse the issue and hinder much needed legislative reform.

Editor’s Notes: As the author of the article “CEO, David Spillers offers thoughts on Healthcare,” Part two in which the misunderstanding occurred I would like to offer sincere apologies to the dedicated men and women who serve as Nurse practitioners.

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In the article I wrote, “A PA has more training than a nurse practitioners and therefore has a greater range of skills.” I have since learned this is not the case, for that sentence I am very sorry. 

Bill Britt

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