With NP bills, patients must be No. 1

Awide range of people have ideas for what's best for patients: The Oklahoman, nurse practitioners (NPs) and even some of our state legislators. However, one voice that has been removed from this discussion is the physician community. Well-crafted media talking points don't tell the whole story. I am writing to clarify why many physicians are concerned about NPs' efforts to increase scope-of-practice through legislation, not education.

First, patient safety should always be at the center of Oklahoma's health care discussion. Regarding claims by The Oklahoman's editorial board that doctors are providing oversight in “name only,” I'd be glad to provide the board with names of numerous physicians who are providing appropriate supervision. In fact, the physician community has gone on record several times to say it is unprofessional and unethical for doctors to accept payment without providing the mandated supervision. If this is a safety issue, shouldn't the NPs first ensure appropriate actions are taken to stop the physicians who are not upholding their end of supervision? I am unaware of any nurse filing such a complaint to the Medical Licensing Board regarding this issue.

The NPs also cite exorbitant supervision fees as a reason for change. But when the state Senate considered legislation last year banning this practice, APRN groups led the charge to kill the bill. I would urge The Oklahoman to simply ask them why.

The NPs state removing supervision could resolve the rural health care provider shortage. Unfortunately, the facts simply do not support this. In the states with expanded NP practice authority, there has been virtually no increase in NPs working in rural counties. Using those states as an example, it is clear that NPs located in Oklahoma's urban areas are less likely to move their practices to rural communities.

Lastly, consider the educational differences between an MD/DO and an NP when determining what is best for Oklahomans. The average physician has at least seven years of post-graduate education and 12,000-16,000 hours of clinical training, while a nurse practitioner has 2-4 years of post-graduate study (some of which is online) and a fraction of the clinical training.

Nurse practitioners are an essential part of a health care team, but they should not replace a well-trained physician. The physician community is strongly opposed to a two-tiered system, where some individuals would have to see non-physician providers for their medical needs.

NPs serve a great purpose in providing quality health care to Oklahomans. But they should function as part of a health care team model that works best for patients.