Overwhelming Majority of Pennsylvanians Say Keep the Care Team Together and “No” to Nurse Practitioners Working Without Physician Collaboration

A poll of 700 Pennsylvanians overwhelmingly indicates the state’s residents do not support current legislative efforts in Harrisburg to allow nurse practitioners to work without physician collaboration, suggesting such efforts are out of touch with most Pennsylvanian residents.

The Patient Poll, conducted March 6-12, 2015, by Susquehanna Polling and Research and commissioned by the Pennsylvania Medical Society, indicates only 15 percent of those polled believe nurse practitioners should be allowed to practice independent of physicians. The poll has a margin of error of 3.7 percent.

Pennsylvania law currently requires nurse practitioners to care for patients as part of a physician-led health care team. Last year, in further support of “team-based care,” the general assembly unanimously approved Act 198 that promotes integration and teamwork among all health care providers.

A small cadre of activist nurse practitioners have been lobbying our state senators and representatives hard to remove physicians from health care teams. Clearly the public does not support those efforts,” says Karen Rizzo, MD, president of the Pennsylvania Medical Society. “Nor do all nurse practitioners, many of which see physician collaboration as key to providing quality care statewide.”

Nurse practitioners are misleading legislators by describing their current ability to see patients as “handcuffed” by existing law. Despite claims that patient safeguards prohibit them from “full practice authority,” nurse practitioners can diagnose, treat, and even prescribe medications just as physicians do, a privilege not seen in many other states.

Nurse practitioners also claim that they are more likely to practice in rural areas and provide care to underserved Pennsylvania communities. Geomapping studies of nurse practitioner practice patterns indicate that is not the case: they are more likely to practice in urban areas. Expanding care to underserved areas involves expanding access to telemedicine, training more physicians, and incentivizing them to work in underserved areas, not fragment the care team.

“Quality medical care for Pennsylvania involves providing access to the most highly educated and best trained medical providers, which are physicians, and working together with other health care providers to effectively treat patients,” says Dr. Rizzo. “There is a reason, a very good reason, why it takes a primary care physician 11 years of education and 12,000 hours of supervised clinical training before Pennsylvania law grants them the authority to practice independently.”

“I can’t imagine why our legislature would want to fragment the care team and grant independent medical practice authority to any professional with less training than a physician,” Dr. Rizzo added. In comparison, becoming a CRNP can take as little as 2 to 4 years of post-graduate study and only 500 clinical hours of training. As the Patient Poll suggests, Pennsylvanians want the assurance that a physician is involved in decisions regarding their healthcare. Why would we consider anything less?”