The annual Pearson Report covers state regulations for NPs in great detail, showing state-by-state where physician involvement is required for NPs to diagnose and treat, and whether physician involvement is required for NP prescribing.
In Alabama, for example, CRNPs are required to work in collaborative practice arrangements with physicians. This constrains their work in rural areas where the need for their services is great. Legislative pushes that would allow NPs to work independently in the state have not yet succeeded.
While doctors groups cite patient safety as a concern, the more urgent issue is lack of access to care. Regulations can and should be amended to enable NPs to take on a greater role in serving the primary care needs of rural Americans.