Nurse Practitioners Push for More Freedom Back Bill Allowing Them to Forgo Supervising Doctor

By Toland, Bill | Pittsburgh Post-Gazette (Pittsburgh, PA), November 24, 2013 | Go to article overview

Nurse Practitioners Push for More Freedom Back Bill Allowing Them to Forgo Supervising Doctor


Toland, Bill, Pittsburgh Post-Gazette (Pittsburgh, PA)


From sick babies to diabetic seniors, Mona Counts has treated thousands of patients, many of whom would travel an hour or more to visit her primary care health clinic in rural Greene County. She knows their family medical histories better than they do because she treated their parents and grandparents over the decades.

"Patients would describe me as an old-time family doc," she said last week.

But she's not a family doctor -- she's a nurse practitioner, and doesn't have an M.D. behind her name (though she does have a Ph.D.). So, despite her wealth of experience, state law says she's not allowed to operate a full medical practice without collaborating with two supervising physicians.

It's a requirement whose utility has come and gone, says Ms. Counts, now in her 70s and semi-retired. Back when nurse practitioners "were relatively new on the marketplace, [doctors] wanted to make sure they would be safe providers of health care," Ms. Counts said. But "the need for that collaborative agreement has just gone away."

That's why Pennsylvania's nurse practitioners are pushing for a change in state law, contained in Senate Bill 1063, that would allow them to practice as independent primary care providers without first signing collaborating agreements with supervising physicians. Eighteen other states, and Washington, D.C., have done the same, giving nurse practitioners "full practice authority."

Nurse practitioners who work in the primary care realm, which is most of them, are able to do many of the things that primary care doctors do -- evaluate patients, order and evaluate diagnostics tests, prescribe drugs, refer to specialists.

Allowing them to function independently could help relieve the oncoming shortage of primary care physicians, said Lorraine Reiser, a director with the American Association of Nurse Practitioners, and a nursing professor at Clarion University.

"When my previous collaborating physician left, I was forced to find another," said Ms. Reiser, who practices at the Hilltop Community Healthcare center in Pittsburgh's Beltzhoover neighborhood.

In Pennsylvania, a nurse practitioner who wants to prescribe drugs to patients must have partnerships in place with a primary physician collaborator, as well as a backup. If those partnerships aren't on file and renewed every two years, a nurse practitioner can't prescribe and, essentially, can't practice.

It may sounds like a mere administrative hurdle, but at times, the requirement acts as a barrier to care, said Kathy Magdic, an acute care cardiology nurse practitioner who practices at UPMC Presbyterian. If a practitioner is operating a clinic in a rural area where there aren't many primary care physicians nearby, it can be difficult to find new doctor collaborators.

If that happens, a nurse practitioner can be "forced to shut down her practice," Ms. Magdic said.

Physicians are also limited as to the number of collaborating agreements they can sign (a maximum of four), and in cases where a physician works for a large medical center, sometimes the center won't permit the doctor to sign a collaborating agreement with nurse practitioners who work outside the hospital network.

And some physicians charge nurse practitioners and their clinics for their collaboration services, adding to overhead expense.

Changing the law in Pennsylvania could take some time, though, if history is an indicator. Pennsylvania was one of the last states to allow nurse practitioners to prescribe drugs. That happened in 2000, and the campaign to give them that authority took more than a decade. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Nurse Practitioners Push for More Freedom Back Bill Allowing Them to Forgo Supervising Doctor
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.