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Author: tjscott0 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 61253  
Subject: Nurse Practitioners vs Doctors Date: 3/7/2013 12:14 PM
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Title of the article "Nurse Practitioners, Doctors in Tug-of-War Over Patients".

My subject title & Business Week's title are a bit of a hype to draw readers.

http://www.businessweek.com/articles/2013-03-07/nurse-practi...

Christy Blanco’s health clinic is sitting empty. A nurse practitioner in El Paso, Tex., Blanco says she has all the necessary equipment and a doctorate in nursing practice that prepared her to perform routine physical exams and treat diabetes, asthma, high blood pressure, and many other common ailments. About 50 miles away in Las Cruces, N.M., dozens of nurse practitioners at clinics like Blanco’s are busy caring for patients. The only difference is that in Texas, nurse practitioners are required to contract with a doctor to sign off on medical charts; the physician must also spend 1 out of every 10 days at the clinic. In New Mexico, no doctor is necessary.

“I’ve spent thousands of dollars of my own money. I have a waiting list of patients, and I have to tell them I can’t practice.”


I'm afraid I'm not too sympathetic toward Ms Blanco. She should have checked the laws & got a doctor on board before opening her business & spending thousands of dollars.

The commute to Las Cruces is only an hour. Some folks in LA or in New Jersey or outer bourghs of NYC have longer commute.

Each state has its rules. And I'm sure financial interests enter the legislative process along with concern for the patient. But like sausage making the process ain't purty but the rules/laws git hammered out. If nurse practitioners don't like the laws in their current state; they have the option relocate. Which apparently Ms Blanco is considering according to the article. Hey health care is a business.

States regulate how much oversight nurse practitioners must have. In 16, including Colorado, New Hampshire, and Washington, they can evaluate and diagnose patients, order diagnostic tests, and prescribe drugs. That means they can start a practice or work out of a clinic with no doctor on staff. The remaining states have a patchwork of regulations. In Florida and Alabama, nurses can’t prescribe certain drugs for pain, insomnia, or attention deficit disorder that are considered controlled substances. In New York, they need a written collaboration agreement with a doctor, and there’s a limit on how many each doctor can work with, effectively creating a cap on the number of nurse practitioners.

A 2009 report by Rand Corp. found no evidence that nurses provide lower-quality care. A 2010 study of nurse practitioners published by the Institute of Medicine, a division of the National Academy of Sciences, recommended an end to state laws requiring doctor supervision.

Apparently nurse practitioners provide a lower cost good solution in patient care as long as they keep within the parameters of health care they are authorized to provide.

I expect alot of future push & pull as nurse practitioners try to expand their scope of duties as doctors attempt to further restrict what nurse practitioners are allowed to do.

The link below shows what your state allows nurse practioners to do:
http://www.bartonassociates.com/nurse-practitioners/nurse-pr...
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