HLM: You say that the legislation "would bring the state into line with national standards and end a disincentive to nurse practitioners." Can you explain this? How is Michigan different than other states? What's the national standard that's not met in Michigan? What's the current disincentive to NPs?
Joanne Pohl: Michigan currently requires physician collaboration, which is often interpreted as "supervision." In reality, it is virtually impossible to sustain such supervision in actual practice. And, again such required collaboration/supervision is not based on any evidence. That is, there is no evidence that patients get better or safer care with such restrictive regulations.
This unnecessarily supervised care—if it is really followed—is also costly, as physicians need to be more involved than necessary and the physicians could be used in better ways such as seeing more patients. Collaboration is a professional ethic that is expected of every provider, not just one. So mandating collaboration for one provider and not others makes no sense, and is frankly impossible to regulate.
This legislation—SB 481—will not expand the scope of practice of Nurse Practitioners. It will simply bring the scope of practice into alignment with what is currently required of every nurse practitioner to graduate and pass Certification Boards. Sixteen other states and the District of Columbia have full plenary authority for nurse practitioners; that means they practice within their required education and training under their own license and are accountable for the care they deliver.