Tuesday, March 29, 2016

75-mile rule approved for nurse practitioners

The Mississippi Board of Medical Licensure is changing the maximum distance a nurse practitioner can operate under a supervising physician's supervision from 15 to 75 miles.  The Board filed an amendment to its current regulations yesterday with the Secretary of State.  The Board held up its end of an agreement made with the legislature last month after a bill with similar language passed the Senate Committee on Public Health.

The notice states that the Board proposes the new regulation become effective in thirty days.

Kingfish note: Hopefully this new regulation can bring more health care to those who need it most or who have been unable to obtain it. 

The new radius is on page five in the documents posted below. 


Anonymous said...

it is a shame that a bill like this is tough to get passed because of the doctors lobby. The medical profession is consumed with greed.

Anonymous said...

True 8:50. As are the associated pharmaceutical and insurance industries. My NP was reprimanded for spending too much time with patients!

Anonymous said...

Physicians want to ensure that patients receive adequate care along with service from providers with the appropriate education to not cause harm to the patients. For example, would you want to have your whole family on a commercial airline with someone with only 15 hours of experience? I would want my pilot to have the adequate training with the proper certifications.

As a recent trainee, I have seen life-threatening complications in patients due to a lack of education in mid-level providers. This is very upsetting, because they were not supervised. This is also the responsibility of the physician that is overseeing them to ensure that they are giving adequate care to their patients. Having over nine years of post-college education, I have learned from some accomplished physicians. These physicians have taught me that the more you know, the less you know. Knowledge acquired allows one to know his or her limitations and when to seek the counsel of others. There are some excellent mid-level providers whom I have worked with that provide great care. This is because they realize their level of knowledge and their limitations.

As for greed, most people do not go into medicine anymore for the money. Realistically, they give up their time and money to become physicians. Current trainees have a minimum of seven years of training, four years of medical school plus a minimum of three years of residency. Most have debt in the hundreds of thousands, average of about $166,000, when they start out in practice about ten years after the college classmates. Also, they have sacrificed a minimum of those seven years of their lives by giving up family holidays and important life events to work to serve others.

@850, you might want to talk to a current trainee to give you some perspective. Would you be willing to give of your time and money to pursue a career in medicine?

Anonymous said...

At 8:50, some physicians might be greedy, but the fact of the matter is physicians are far more trained than nurse practitioners. Hmmm have you ever thought why a Registered Nurse would want to become a Nurse Practitioner? It would be fair to say a major reason is for more money (greed). The reason above outweighs the reasons of help and care because they are already providing those valuable services in their current roles as registered nurses. Yes, I see the need for Nurse Practitioners but in a clinical setting as part of medical providing team with a physician PRESENT and ACTIVE with each patient. I do not agree with Nurse Practitioners working in independent settings where a physician only has to review 10% of their medical charts with no true accountability for the remaining 90%. Bottom line is Nurse Practitioners should never have the ability to work without a physician present. I for one rather see a physician than a Nurse Practitioner. P.S. For those of you who enjoy getting mad that our legislature hasn't done enough to provide medical services to rural Mississippians, call up you legislator and demand him or her to support in the future increased funding in Mississippi's Rural Physician Program. That way we get more physicians in rural Mississippi who have more expertise and not Nurse Practitioners.

Anonymous said...

Weren't they already granting waivers for collaboration beyond 15 miles if the NP could not find a collaborating doc? If so, this just gives the NPs more leverage in their negotiations with the collaborating docs (not a bad thing).

Anonymous said...

10:18 and 10:44 - I am in the medical profession and you are both 100% correct. Well said.

Anonymous said...

12:26 I agree, but for those consumed with class envy none of these facts matter.

It's just not fair somebody earns more than me! I want Bernie to give me free everything because, well, reasons and stuff.

Dr Feelgood said...

If someone entered the medical field because of greed, they could have done better elsewhere. Most doctors are in debt with medical school loans, insurance and the cost of starting a practice. To think otherwise is just ignorant. What other profession gets called into work in the middle of the night?

Doc Adams' Black Bag said...

If my transmission is slipping I don't want to be directed to turn in at the next oil change shop.

None of this has one thing to do with professionals insisting on quality care. For the NP it's all about making more money and enjoying the status. For the doctors, it's all about having fewer demands on your schedule during the day, sloughing off patients that can meet the requisite dots and dashes to be seen by a lesser qualified practitioner.

Ask any nurse who is enrolled in or considering NP training for her own career. She will tell you she's doing it to make more money. You'll not hear a ONE say 'in order to ensure that patients can have quality care at a more reasonable cost and quicker'.

Anonymous said...

Sorry, the original bill failed all about money. The doctors charge between $2,000 and $4,000 per month to collaborate per NP. This is $2,000-$4,000 for 30 minutes to an hour worth of work reviewing 20 charts from the previous month. If an emergency happens in the clinic, they are going to call 911 for an ambulance not their preceptor. If care for a patient is out of their scope of practice, they are going to refer them to a someone that specializes in their area of need. It has been proven in other states and a study by the FTC that NP's safely fill the PCP role in rural ares without a collaborating physician.

Anonymous said...

I'm pretty sure this will not be official until Dr. Easterling approves it. He is after all the face of all doctors in Mississippi. Maybe he can go on Supertalk and explain. Afterward Pandering Feel can go on and comment. That way, we will get a fair and balanced explanation.

Anonymous said...

It doesn't matter how much training a doctor has if you can't afford to go to him. If I have a sinus headache, why do I need a specialist to prescribe Sudafed that I used to buy over-the-counter. I go to NP'ers all the time for minor things. It doesn't cost as much, and I'm still very much alive.

Anonymous said...

Well, for those of you who liked or didn`t like that bill, it was defeated. Why? The Miss Nurses Assn director wants independent practice for all NPs and will accept nothing less. No physician collaboration, no supervision, no input into quality assurance, no checking on narcotic prescribing, no review of bad outcomes, no backup for clinical emergencies, and no OJT for clinical procedures. A collaborating physician over 75 miles away has NO IDEA what that NP is doing. All the hoopla over APRN, CRNA, CNM, and NP is a smokescreen, as is the charge that the licensure board has broken any agreement with Hob Bryan. Wonder just how much lobbying money was given to Sen Bryan and Sen Burton to continually push this stuff? $4,000.00 monthly for a collaborating physician? No, not in this state. Wonder where that number came from?

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