How Mississippi avoided an untested scope-of-practice model

Kevin B. O'Reilly , Senior News Editor

What’s the news: Mississippi state senators are not moving forward with legislation that would have allowed advanced practice registered nurses (APRN) to practice without any physician involvement and allow nurse practitioners (NPs) who meet certain requirements to serve as the collaborating or consulting provider for all four types of APRNs.

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That’s a move not permitted in any other state and would have “Mississippi on a crash course toward worsening health outcomes and higher costs,” AMA Executive Vice President and CEO James L. Madara, MD, wrote in a letter to Lt. Gov. Herbert Hosemann. The Senate committee of jurisdiction has decided against taking up the measure, House Bill 1303, effectively killing the legislation.

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The AMA stood firm with the Mississippi State Medical Association (MSMA) in letting lawmakers know this proposal was a dangerous path forward. For years, the MSMA has worked to educate Mississippians about the value of the physician-led health care team.

Why it’s important: There is a vast difference in education and training of NPs compared with physicians, as well as a distinct difference in education and training among NPs and other APRNs.

All that combined to make the bill particularly dangerous since “nurse practitioners do not have the education and training to practice without physician supervision themselves and certainly do not have the education and training to supervise other APRNs beyond their own scope,” Dr. Madara wrote.

Dr. Madara also addressed claims that H.B. 1303 was necessary to increase access to care in rural areas.

“This promise has been made in many other states, but it has not proven true,” wrote Dr. Madara. “In reviewing the actual practice locations of primary care physicians compared to nurse practitioners and other APRNs, it is clear that physicians and APRNs tend to practice in the same areas of the state. This is true even in those states where nurse practitioners can practice without physician involvement.”

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Learn more: Patients deserve care led by physicians—the most highly educated, trained and skilled health professionals. Through research, advocacy and education, the AMA vigorously defends the practice of medicine against scope-of-practice expansions that threaten patient safety.