Lawmaker Renews Push For Expanding Nurse Practitioners' Scope Of Practice

Jan 10, 2014

The federal Health Resources and Services Administration says at least 55 million people around the country live in areas that lack an adequate supply of primary care doctors. Now, some Florida lawmakers are looking to remedy that by expanding what Nurse Practitioners are allowed to do.

This isn’t the first time Tallahassee Democratic Representative Michelle Rehwinkel Vasilinda has advocated for making nurse practitioners more independent. Last session she spearheaded an effort to allow nurses to prescribe certain medications without a doctor’s supervision. Now, she’s pushing for full autonomy, allowing them to run their own clinics, prescribe medication and be reimbursed by Medicaid in the same way a doctor is. Although Vasilinda insists she isn’t trying to ignite a civil war within the medical community, she is issuing a call to arms to solve a looming doctor shortage.

“The people of Florida need access to healthcare, they need quality healthcare and they need lower cost of healthcare. And all those things are important and I say all hands on deck. There are fifty states in this union, forty-nine of them allow nurse practitioners full scope of practice, or fuller scope of practice than Florida,” Rehwinkle Vasilinda said in a Friday press conference.

Most states have increased a nurse practitioner’s scope of practice by letting them make some decisions without a doctor’s supervision. But, the American Association of Nurse Practitioners says only 17 states allow full scope of practice. Florida Academy of Family Physicians’ Director Jay Millson it’s a good thing the other 33 don’t. He argued nurse practitioners aren’t as well-trained as doctors and thinks the problem has more to do with apportionment than an actual shortage.

“We believe that there’s plenty of workforce to take care of the patients that are out there. It just needs to be redefined in the way in which the care is provided. What I mean by that is putting care in the way of patient center, medical homes or in teams. We believe it should be led by a physician with the nurses working with them,” Millson explained.

But federal healthcare statistics do support the idea that there’s a shortage and with older doctors reaching retirement, officials worry the problem will only worsen. Milson says the state can do more to increase its physician base by implementing broader loan forgiveness programs for prospective doctors looking to work in primary care. A flurry of proposals regarding the doctor shortage and role of nurse practitioners is expected in the upcoming legislative session.