New bills could lift restrictions on nurse practitioners

SPRINGFIELD, Mo. (KY3) -In Missouri nurse practitioners need to work with a collaborating physician to provide care. A report shows there is a physician shortage across the United States. Missouri lawmakers and congress are each considering bills to allow nurse practitioners to work independently.

The ICAN Act, Missouri HB 271, and SB79 all propose legislation certifying advanced practice nurse practitioners to treat and care for patients without a collaborating physician. If this legislation passes, it will lift restrictions on nurse practitioners when it comes to offering care to patients. 26 states have already approved full practice authority and have high quality of care ratings. One of the points of resistance to passing this kind of legislation is the difference in education and training for physicians and nurse practitioners.

“The amount of training that the nurse practitioners have to be practicing is far less, in some respects less than 10% of what a physician has, day to day,” said John Burroughs with the Missouri Academy of Family Physicians. “Routine types of visits and in some cases, very specialized visits within some specialties, mid-levels can do a wonderful job, but our education is driven on seeing as many things as we possibly can so that when things aren’t routine, that we have that ability to have an idea of treatment or diagnosis, the quality of care can be decreased with a mid-level provider, just based on the education and training levels.”

“To be a nurse practitioner, you have to have a nursing background,” said Nurse Practitioner Deborah Blinzler. “A lot of us have had 20-30 years of experience before going back to school. That gives us the experience. We have our base, BSN. Then we go on for our MSN or the doctorate. So we have three or two to three years on top of that. Then physicians go on for a residency, which is more training, but we’ve had 10 to 15 years of training. Our education is equivalent to lawyers who go seven to eight years. It’s equivalent to or optometrist, ophthalmologist and it takes teamwork it takes all of us.”

Let’s say you need healthcare but can’t get in to see a doctor for weeks or even months. You might be referred to a nurse practitioner. Now nurse practitioners are fully capable and licensed to help you with your health care under certain restrictions. One of those restrictions is that they must work with a collaborating physician that is within 75 miles. This means that if the doctor is on vacation or chooses to work in a healthcare system that is farther away, that nurse practitioner cant see patients until the doctor returns or a new collaborator is appointed. With an ongoing shortage of physicians, nurse practitioners believe that lifting these restrictions will help fill the gap in healthcare services but physicians have a different perspective.

“If they can’t do a procedure, we can’t do a procedure,” said Blinzler. “I lost my first collaborator, and I was doing a procedure. And when I got my new collaborator, he had never needed to do that. That’s how he didn’t. And although I was trained, I could no longer do that procedure because he was not.”

“Unfortunately, I just don’t see that independent nurse, nurse practitioner licensing is really going to fix the problem that we’re looking to fix,” said Burroughs. “Which is bringing more health care to those areas. For us, it’s not that we think that nurse practitioners provide care. It’s just that we certainly hope that the training that we go through for the physician route gives a lot more of that experience and a lot more quality of care to our patients.”

Click on the following links for more information on each bill.

ICARE Act

SB 79

HB271

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