Texas nurses say giving them more autonomy and an expanded role in providing medical care to patients could help expand access to care, and bring down medical costs, News Radio 1200 WOAI reports.
The two Registered Nurses in the Legislature, Democratic State Rep Donna Howard of Austin and Republican State Rep. Stephanie Klick of Ft. Worth, have banded together to introduce a measure that would end the need for Advanced Practice Registered Nurses, which are nurses who have a Bachelor of Science in Nursing or other training over and above that required for R.N. status, to be able to practice medicine without have to enter into a 'delegation agreement with a physician.
Klick said the requirement for that agreement is expensive, costing APRN's as much as $120,000 a year, and if the physician retires or moves, that places the APRN's practice on hold under another agreement can be reached.
"Texas ranks 47th in the nation in the number of primary care physicians per capita," Klick said. "Out of 254 countis, do not have a single physician."
And she says unlike many doctors, APRN's are frequently able to accept patients that same day to deal with urgent medical issues.
Klick and Howard's bipartisan bill would allow APRN's to essentially perform all of the traditional family practice duties of a physician, from prescribing medications and treatment, accepting controlled substances, perform tests and interpret test results, and APRN's would be allowed to be listed as a patient's 'health provider of record' for insurance purposes.
"APRN's are already trained and equipped to provide these services for Texans," she said.
Klick says other states which already allow what is called 'Full Practice Authority' to APRN's are actively involved in recruiting APRN's in Texas to go to other states where they have more authority, and are freed from burdensome and costly delegation agreements with physicians.
She says the need for those agreements is outdated.
"More than forty years of academic research on the topic has consistently shown that APRN's have similar or better clinical outcomes when compared to physicians," Klick said.
The bill is part of the 'disruption' of traditional medical practice which is beginning to emerge in several areas. Neighborhood emergency clinics, once referred to derisively as 'doc in the box's' are taking an increasing share of the walk in emergency business from hospital ER's, which is forcing hospital emergency rooms to reconsider their cost structure.
And non traditional businesses are exploring getting into the medical industry. Walmart, for example, is considering offering MRI's and other emergency services at certain locations, with the support of insurance companies, which see this as a way to bring down medical costs.
IMAGE; GETTY