Dr. Rizzo Responds to CRNP Claims: It’s about Training, Not Injustice

In response to an op-ed in which the American Medical Association was accused of “social injustice” in opposing independent practice for nurse practitioners, based on the fact that most nurse practitioners are women, Karen Rizzo, MD, president of the Pennsylvania Medical Society (PAMED), spoke out.

“As president of the Pennsylvania Medical Society, and a woman, I can state emphatically that our opposition to independent practice for nurse practitioners has nothing to do with the repression of women, a notion I find both abhorrent and ludicrous,” she said in her response, which was published on Penn Live on Dec. 3.

“Our position on the issue was determined by sound clinical reasoning, based on education, training, and expertise,” she said. “In other words, patient safety.”

She went on to cite the education and training differences between physicians and nurse practitioners — physicians receiving four years of education in medical school, followed by three to seven years of residency and 12,000-16,000 hours of patient care training, and nurse practitioners only two to four years of education (some of which can be completed online) and 500-720 hours of patient care training.

PAMED supports physician-led team based care, in which the physician is the leader of the team, but all health care practitioners work collaboratively to provide the best possible patient care.

“We fail to see how eliminating physicians, with their 12,000-16,000 hours of training, from the team will improve care,” said Dr. Rizzo.

“Nurse practitioners are valuable members of that health care team. However, CRNP independent practice, which would sever the collaborative tie between physicians and CRNPs, would lead to fragmented care and is antiethical to the team-based approach,” she said.

PAMED encourages nurse practitioners to work with physicians to improve patient care, and supports legislative initiatives that promote physician-led team based care.

One such initiative, a bill that was recently passed by the state legislature, creates a Patient-Centered Medical Home Advisory Council to advise the Pennsylvania Department of Human Services (formerly the Department of Public Welfare) on how the state’s Medicaid program can increase the quality of care while containing costs through a variety of patient-centered medical home approaches.