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NY nurse practitioners want less oversight

ALBANY -- Midwives freed themselves from doctors last year, and now nurse practitioners want the same.

A bill before the State Legislature would eliminate the state mandate that requires nurse practitioners to be supervised by doctors. If the measure is adopted, New York would join 16 states and the District of Columbia that do not require physician supervision.

"Without that restriction, nurse practitioners would be free to enter into their own practices and practice autonomously," said Seth Gordon, president of the Nurse Practitioner Association of New York State.

Nurse practitioners are registered nurses who have master's degrees and advanced training. They are allowed to make medical diagnoses and prescribe drugs. Under current law, an nurse practitioner must have a collaborative agreement with a physician that requires the doctor to review the practitioner's care every 90 days -- but the review can be as minimal as looking at a single patient chart.

Gordon said the review is "unnecessary, because every health care professional has a responsibility to collaborate with other health professionals." Nurse midwives who are trained to deliver babies won legislation last year that removed the physician supervision requirement.

The Medical Society of the state of New York opposes the bill. "MSSNY believes that further fragmentation of care is not consistent with enhanced quality and will increase, rather than constrain, overall health care costs," it said in a statement.

New York has 15,000 licensed nurse practitioners. About one-third practice in hospitals, one-third in outpatient settings, and less than 10 percent have private practices, Gordon said.

Removing the physician supervision requirement would allow more nurse practitioners to start solo practices and fill the gap in areas where there aren't enough doctors, Gordon said.

"We know there are 2 million people in this state that reside in medically underserved areas, both urban and rural," he said. "This provides patients access to care without costing money. There is no good reason not to do it."

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