New Oklahoma House Bill Would Allow NPs to Work Independently of Physicians

This week, Oklahoma introduced a bill making it easier for nurse practitioners (NP) and other advanced practice registered nurses to work independently, without a supervising doctor, according toNewsOK.

NP Toni Pratt-Reid, president-elect of the Association of Oklahoma Nurse Practitioners, which is pushing for the law, said it is a common misconception among patients that high-level nurses need physicians’ approval for every case, when really it is more of a collaborative effort.

“There’s no oversight to our practice on anything other than prescriptive needs,” Pratt-Reid toldNewsOK. “There might not even be a physician that communicates with us for 2 years.”

However, Art Rousseau, psychiatrist who chairs the Oklahoma State Medical Association’s legislative committee completely disagrees with Pratt-Reid’s description.

“[NPs]in Oklahoma do not have a collaborative relationship with a physician,” Rousseau said, as reported byNewsOK. “They are to have a supervisory relationship with a physician. There’s a difference, and a significant difference.”

In fact, if there’s no communication between the 2 about the nurse’s patient, it’s against the law, according to Rousseau. The medical association opposes the bill,NewsOKreports.

The House Bill 1013 was introduced by state Rep. Josh Cockroft, R-Wanette, and some individuals believe that the bill will help alleviate Oklahoma’s health care shortage.

In a news release, Cockroft wrote that many agreements are unused.

“This makes the requirement meaningless and only slows Oklahoma’s—–particularly those in rural areas––access to valid health care services,” Cockroft said. “It already is hard for those in rural areas to find adequate services, and frankly this rule hampers economic development in our rural communities.”

Currently, state law limits how many agreements a physician can sign. Pratt-Reid toldNewsOK, that without agreements in place the nurses would have more ability to practice in parts of the state with a high medical need.

“We’ll be able to keep the practitioners that are homegrown in our state here and get them to go back home to wherever they’re from, and open up the doors to their hometown,” Pratt-Reid said.

It’s still in question whether the legislation will truly expand primary care providers in areas of the state lacking in medical care.

“Unless they plan to have a great mass movement out into the rural area, this (bill) is just to expand their scope of practice,” Rousseau said, as reported byNewsOK. “The nurse practitioner is there to also provide care, but under the supervision of the physician. Basically the NP is saying, ‘I want to be a doctor.’”

A typical agreement costs a nurse between $10,000 and $50,000 per year,NewsOKreported. Pratt-Reid said that there are nearly 2 dozen states that don’t require high-level nurses to work with a supervisory physician.