The Institute of Medicine on Tuesday released a report calling for a larger role for nurses in the delivery of healthcare and in the implementation of healthcare reform.

Nurses should be able to practice more independently from physicians, according to the report. It calls on both federal and state governments to allow advanced practice nurses to practice to the fullest extent of their training. In its report, the IOM notes that as many as 250,000 nursing in the U.S. are advanced practice registered nurses, with either a master’s degree or a doctorate in nursing. Many states do not allow qualified nurses to prescribe medication without physicians’ supervision, according to the report.

The report addresses the longstanding battle between nurses and physicians over the role of nurses in healthcare, Kaiser Health News reported. Nurses must be “front and center in the healthcare system” if there are to be significant improvements in the quality of healthcare or coverage, according to Donna Shalala, former Health and Human Services Secretary and current chair of IOM’s committee on the future of nursing.