Pennsylvania Considers Expanding NP Practice Authority

A bill under consideration by the Pennsylvania State Senate would allow nurse practitioners (NP) to practice independently.

Currently, NPs in Pennsylvania can practice autonomously only if they have collaborative practice agreements with 2 physicians. Notably, those physicians can end those collaborations without notice.

Under the proposed legislation (SB 717), NPs would be able to practice independently after they complete 3 years of collaboration with a physician and 3600 practice hours.

Opposition to the bill in Pennsylvania echoes opposition to similar efforts in other states. Many practicing physicians believe that NPs don’t have the requisite education to diagnose and prescribe medications for chronic and acute conditions.

“With a shortage of both nurses and physicians, increasing the responsibility of nurses is not the answer to the physician shortage,” Rebecca J. Patchin, a board member of the American Medical Association,previously said. “Nurses are critical to the health care team, but there is no substitute for education and training.”

Instead, the Pennsylvania Medical Society argued, patients are best served when physicians and NPs work in tandem. The group believes that SB 717 would disrupt the collaborative nature of team care that currently exists between physicians and NPs.

The results of a study conducted by the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing suggest that removing such barriers to NP authority would greatly expand access to treatment and medications to traditionally underserved patient populations, including rural communities, Medicaid recipients, and the elderly. Specifically, the study found that practices with NPs are 23% more likely to accept Medicaid patients.

“Patients in our state deserve access to the full extent of the education and training that nurse practitioner’s receive,” Lorraine Bock, DNP, FNP-C, ENP-C, FAANP, president of the Pennsylvania Coalition of Nurse Practitioners, told theCentral Penn Business Journal. “It is time for Pennsylvania to join the growing number of states that enable nurse practitioners to serve the healthcare needs of seniors, rural communities, and all patients.”

The proclivity of patients to turn to NP-run clinics instead of a primary care physicians (PCP) has been growing due to the rising cost of health care and shortage of PCPs. According to the Association of American Medical Colleges, the shortage of physicians is projected to exceed 46,000 within the next decade, and NPs have been called upon to help fill the void.

The requirement for NPs to collaborate with physicians has already been modified in 21 states and the District of Columbia.