Two bills recently introduced in the Texas legislature would allow advanced practice registered nurses to provide care to patients without physician supervision, as reported in the Austin American-Statesman.
Senate Bill 681 and House Bill 1415 seek to address a significant physician shortage in Texas. As reported in the Statesman, one analysis found that 35 of Texas’ 254 counties have no physician at all. 20% of Texas residents–an estimated 4.6 million Texans–have no access to a primary care provider.
In 2013, the legislature passed a law allowing advanced practice nurses to treat patients, as long as a doctor “supervised” their work. However, the Texas Tribune revealed that the law had inadvertently resulted in a costly “pay to play” system, with nurses paying as much as $120,000 per year, for supervision agreements. In response, many nurses moved to neighboring states like New Mexico, causing a “brain drain” in Texas that exacerbated existing care shortfalls.
SB 681 addresses the situation by permitting advanced practice registered nurses to “practice as a licensed independent practitioner,” with specific standards for care that these nurses must meet. HB 1415 contains similar provisions. The bills would also place advanced practice registered nurses entirely under the oversight of the Texas Board of Nursing. Currently, they are regulated by both the Texas Board of Nursing and the Texas Board of Medicine. This makes them the only health professionals in Texas who must answer to both boards, according to the Statesman.
The Texas Tribune has found that the bills have the support of a number of patient- and business-related organizations including the AARP, the Texas Association of Business and the Texas Public Policy Foundation. Meanwhile, the Texas Medical Association has voiced its disapproval. In an interview, TMA president Don R. Read argued that a “team care” approach serves patients best, and the best solution is to attract more physicians to Texas.
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