FLORIDA NURSE PRACTITIONERS FIGHT FOR AUTONOMY
By Albert R. Meyer, JD, MHA
Florida nurse practitioners are a vital part of the health care delivery system in the Sunshine State. The 19,000 nurse practitioners treat ailments ranging from sinus infections and sore throats to more specialized procedures with dermatology practices. However, they can’t do it alone. Currently, Florida law requires a nurse practitioner to work under the collaboration with a licensed medical doctor and cannot be considered primary care providers. Additionally, Florida nurse practitioners only group of their in the nation that cannot prescribe controlled substances under any circumstances.
In an effort to gain more autonomy nurse practitioners are lobbying legislators. The nurse practitioners are asserting that they have adequate education and training to become bona fide primary care providers. The Florida Medical Association (“FMA”) disagrees. While the FMA concedes that there may be some needed changes in current supervisory/collaboration model, it feels that allowing nurse practitioners to practice independently would put patient safety at risk.
The FMA, in support of its position, maintains that the training of a nurse practitioner is inadequate to allow for an independent practice. For a medical doctor to be able to practice, he/she must complete four years of medical school and a residency of around three years. Compare this to the education and training of nurse practitioner which is typically one and a half to three years. Nurse practitioners counter that argument by demonstrating that most nurse practitioners have more than five years of hands on clinical experience before training to become a nurse practitioner.
To address this issue, the Florida House of Representatives have form a Select Committee on Healthcare Workforce Innovation. The committee will be hearing testimony today from both sides of the issue, presumably with the intent to bring recommendations to the Florida legislature when it convenes in March.
The case for nurse practitioners should be taken seriously. Research groups and government agencies predict that by 2020, the US will face a shortage of primary care physicians of up to 50,000. That figure may increase even more with millions newly insured people flooding the health care system as a result of the Affordable Care Act and the thousands of physicians who will opt out of participating in private and government payment programs for cash based practices. This situation in Florida may be far worse than other states, given Florida’s high elderly population. Even with the increase in foreign medical graduates in recent years, that supply of physicians will likely not be able to meet the demand for increased access to health care services.
Currently, 27 states and the District of Columbia allow nurse practitioners to practice independently with no physician involvement. Florida needs to seriously consider joining those ranks.
Citizens are already complaining that they must wait weeks or even months to get into see a primary care physician as a new patients. The unfortunate result will be a significant decrease in the access to care; the opposite of what Affordable Care Act promised.
Let’s hope these groups can put their own self-interests aside and come up with a primary care delivery system that can benefit all Floridians.
Mr. Meyer is an attorney with over 20 years’ experience in health care law focusing on regulatory and transactional matters. His clients include physicians, medical equipment companies, surgery centers and diagnostic centers. He can be reached at 866-585-5444 or firstname.lastname@example.org.