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Nurse Practioners Get More Independence in Patients’ Care

Patients should get faster medical care and more places to receive it under a new law that gives increased authority to nurse practitioners, say supporters of the law.

“It eliminates barriers that once prevented nurses from working in their full scope of practice,” said Dr. Joyce Griffin-Sobel, the dean of the State University of New York Upstate Medical University nursing school.

The new law — called “The Nurse Practitioner Modernization Act” — allows nurse practitioners in New York with at least 3,600 hours of experience to treat patients without a supervising physician. It takes a full-time nurse practitioner roughly two years to reach 3,600 hours, according to the Nurse Practitioner Association New York State.

The law expanding nurse practitioners’ independence from doctors was sponsored by State Assemblyman Richard Gottfried, D-Manhattan. It takes effect Jan. 1, 2015, and it will expire in 2021 unless it is renewed. New York is the 19th state to give nurse practitioners this new authority.

There are more than 16,000 nurse practitioners in New York state and more than 1,000 in Onondaga, Oswego, Cayuga and Madison counties. These nurse practitioners have long had authority to diagnose and treat patients.

But now they can practice without a doctor checking up on them. Nurse practitioners handle a patient’s care from start to finish: from the diagnosis of high blood pressure, for example, to the prescription of the necessary medication and lifestyle changes.

The law was opposed by doctors, who argued that physicians should have the final decision in treatment. But supporters say the law will:

  • Maintain collaborative relationships between nurse practitioners and physicians so that nurse practitioners will still be able to consult with doctors when a patient has problems that exceed their level of expertise.
  • Provide nurse practitioners with a panel of specialists to whom a patient can be referred.

“Just like a medical doctor can’t do surgery, a nurse practitioner would have a panel of people to whom she could refer a client who needs more complicated care,” nursing school dean Griffin-Sobel said.

  • Require nurse practitioners to file the details of their treatment with the State Education Department if they consult a specialist.
  • Eliminate the fee they’ve had to pay to practice in a partnership with a doctor.

As lawmakers considered the measure, physician associations opposed the bill. In a statement to local associations, the statewide doctors’ professional organization, the Medical Society of the State of New York, argued that granting more independence does not necessarily increase access to care.

The new measures don’t add enough diverse care because nurse practitioners “must have a collaborative relationship with a physician in the same specialty,” according to the statement.

That essentially means the newly independent nurse practitioners aren’t offering broader care, said James Coulthart, executive vice president of the Onondaga County Medical Society. It is the local professional organization for doctors. Instead, there are more options in only very specific fields of medicine.

“If the goal is to see more people, then specialization doesn’t help,” Coulthart said.

Some physicians support nurse practitioners’ independence, Coulthart said. And nurse practitioners do allow doctors to see more patients in their specific field, he added.

If broad, primary care is the goal, he said, collaboration is necessary for smooth and efficient workflow. “There needs to be somebody at the end of the chain that has the final word, supported by training and expertise,” Coulthart said.
(Joe Infantino is a senior majoring in newspaper and online journalism with a minor in anthropology.)


Posted in Spring 2014 | Comments Off on Nurse Practioners Get More Independence in Patients’ Care