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Should Nurse Practitioners Be Given More Autonomy?




Madison Tolchin visits Paula Glass, an advanced registered nurse practitioner, for a health checkup at a Planned Parenthood clinic on April 14, 2017 in Wellington, Florida.
Madison Tolchin visits Paula Glass, an advanced registered nurse practitioner, for a health checkup at a Planned Parenthood clinic on April 14, 2017 in Wellington, Florida.
Joe Raedle/Getty Images

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In an effort to address California’s dire physician shortage, legislation that is working its way through the state legislature would allow nurse practitioners who receive special training and certification to practice on their own and without needing the agreement that is currently required from a supervising physician that outlines what kind of care and treatment the NP can provide.

If the proposed law sounds familiar, it’s because the idea has been legislated before, both here in California and elsewhere. 22 other states and the Veterans Administration have created similar carve outs for NPs in an effort to meet the demand for care. The new law, which was introduced last year and passed the State Assembly last month, would not expand the scope of the care NPs can provide but instead remove the supervisory rule that requires a physician be at least on-call, if not physically present, during the patient’s visit with the practicing NP. Supporters of the legislation say given that more than 58 percent of NPs in California provide primary care, the law would not only address the state’s doctor shortage but also provide access to care for underserved patients in rural areas and low income neighborhoods and potentially attract other NPs to come to California where they can practice more freely.

But doctors and groups like the California Medical Association that represent them have pushed back on the idea in the past, arguing that allowing NPs to practice independently could lead to lapses in care because while they are well-trained, physicians argue, they only complete a fraction of the hours of clinical training time that those on the physician track do. The CMA says it supports a solution that involves improving physician graduation rates and finding ways to incentivize doctors to work in underserved areas, something that they note AB 890 does not require.

Today on AirTalk, we’ll hear perspectives from both nurse practitioners and doctors about the legislation. If you’re a licensed physician or NP and would like to share your perspective, join the live conversation by calling 866-893-5722.

Guests:

Theresa Ullrich, licensed family nurse practitioner with St. Joseph’s Hospital in Orange, CA and immediate past president of the California Association for Nurse Practitioners (CANP), an organization representing more than 22,000 registered nurse practitioners statewide; CANP is also part of “Close The Provider Gap,” a coalition of groups that support AB 890

 Janus Norman, senior vice president of governmental relations for the California Medical Association, a professional organization representing 48,000 physicians statewide; the CMA has signed on in opposition to the bill