Nurse practitioners want less physician oversight

Posted at 6:38 PM, Aug 06, 2019
and last updated 2019-08-06 20:19:04-04

MCMINNVILLE, Tenn. (WTVF) — Some nurse practitioners want state law to change to allow nurses to practice medicine without the oversight of doctors.

The Tennessee Nurses Association is pushing for removal of a law that requires nurse practitioners to pay a physician to monitor their clinics.

"It's the state legislature that mandates that we have to have a supervising physician," said Theresa Hill, a family nurse pracitioner in McMinnville. "So, there are quite a few states in the United States where the nurse practitioners do not have a supervising physician."

Hill owns Family Care Clinic. She said while she partners with a physician to run her practice, she doesn't think she would have to have one to operate.

"For a family practice, for most patients, nurse practitioners can take care of 80% of the problems just as well as physicians do," she said.

Hill said she's worried about her practice and others who live in rural areas. She said the doctors around McMinnville are aging or close to retirement. If those doctors leave, she's worried some may have to close their clinics.

Clinics are required to have a physician review 20% of their charts, review prescriptions for controlled substances and the physician must visit the clinic once per month.

"We are trained to write those prescriptions, we are trained to see those patients. We are under the governance of the board of nursing," she said. "The legislature has allowed that the board of medicine have some supervision for another profession."

However, the Tennessee Medical Association has pushed for the relationship to stay linked.

"Physicians and nurses have worked together in teams as long as there has been physicians and nurses," said president-elect Dr. Kevin Smith of TMA.

Dr. Smith said there's an education and experience difference between nurses and physicians. TMA representatives are not opposed to some sort of law change to make operations easier for nurse practitioners, though.

"Certainly, physicians could talk to their nurse practitioner colleagues by phone," said Smith. "A lot of this could be taken care of via telemedicine or over a shared EMR (Electronic Medical Record), something like that. So, the remoteness of the location is not as big of a problem as it was back in the day when you had to have a physician physically present with a nurse practitioner."