The Ohio Academy of Family Physicians will soon launch a web site page designed to help OAFP members make the case with their state legislators that they should oppose House Bill (HB) 216. As introduced, HB 216 would allow advanced practice nurses (APRNs) to practice independently without a standard care arrangement with a collaborating physician. The bill’s sponsor is Representative Dorothy Pelanda (R-Marysville, OH). The bill has been assigned to the House Health and Aging Committee for consideration.
- HB 216 fragments health care. Independent practice for additional health professionals undermines team-based care creating silos and further fragmenting patient care. In team-based care:
- APRNs and physician assistants (PAs) are more likely to take care of stable, chronically ill patients, to take care of patients after the patient’s diagnosis has been made by a physician, and to provide patient education and wellness coaching.
- Physicians are more likely to care for more complex diseases/syndromes, patients with multiple chronic conditions, and to make the initial diagnosis
- Physician-lead teams assure that the most appropriate care is made available to patients.
- APRNs would have you believe that HB 216 is about access and that if HB 216 passes, APRNs will flock to underserved areas to provide primary care. The truth is there is nothing, under current standard care arrangements, preventing an APRN from going to a rural community right now. HB 216 is not about access to primary care as:
- Only 12% of APRNs practice in out-patient settings.
- Most APRNs are practicing in sub-specialties, not primary care; only an estimated 30% to 35% of APRNs practice primary care.
- The education and training of physicians are unsurpassed. Physicians have at least 11 years of education and training while APRNs have 5.5 to 7 years education. The training of an APRN is more equivalent to a third year medical student than a primary care physician who has completed four years of medical school and a three year residency program. Patients highly value the additional education and training that physicians receive. Surveys show that that 90% of patient respondents feel a physician’s additional years of medical education and training are vital to optimal patient care.
- Ohio needs greater accountability over prescribing, not less. Yet, HB 216 would allow Ohio’s more than 10,000 APRNs to prescribe medications—including addictive and dangerous Schedule II drugs, such as, Hydrocodone, Methadone, Morphine, Oxycodone, Percocet, Fentanyl, and Vicodin – without consulting a physician.
- HB 216 unreasonably expands the scope of practice for APRNs. If HB 216 passes, APRNs would be able to order and interpret diagnostic tests, prescribe addictive narcotics and develop treatment plans without consulting a physician.
While APRNs have a unique and important role in health care they have not completed medical school and residency training that affords them with the same knowledge, training, experience and skills as those who have completed medical school and residency training. The roles of a physician and a nurse are not interchangeable.
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