Changing roles for nurses
Regarding the story “Mich. doctors wary of bill to expand nurse practitioners’ role” (ModernHealthcare.com, June 10), while in a hospital, are nurse practitioners employed by the hospital? Are they independent contractors? Are they credentialed by the hospital? What about liability? Seems to be a waste of legislative time if hospital privileges and working in a physician practice are the only issues. I have seen many registered nurses work as hospitalists and as advanced practitioners in hospitals and physician practices. The only clinical limitation was the registered nurse could not make a medical diagnosis, and in a physician practice, a physician was required to be in close proximity in order for the physician to bill Medicare. When a medical diagnosis is made without a supervising physician, I see the lawyers having a field day. Then you really need to determine if the NP and M.D. are interchangeable.
Robert Starkweather Consultant Louisville, Ky.