Nurse Practitioners Push To Practice Without Doctor Supervision


By Sheldra Brigham

Oklahoma nurse practitioners have asked the legislature to amend the Oklahoma Nurse Practice Act to free them from doctor supervision.

“I provide primary care services. I do the well exams, I make sure the kiddos are vaccinated. When they come in sick, I diagnose and treat the strep throats and ear infections with antibiotics,” said Elizabeth Carlton.

She’s a nurse practitioner at Next Generation Pediatrics. To treat patients, she has to pay a medical doctor for supervision.

“We often have to pay thousands of dollars a year for this to be in place” she said.

She’s one of many nurse practioners backing a bill that would do away with supervision contracts.

Damarcus Nelson is another.

“We need to change it because we need to allow Oklahomans to have better healthcare,” said Nelson.

He says the contracts provide little oversight and forces them to pay fees to doctors who never step foot in their facility.

He says those fees can be as high as $25,000 a year.

“I'm seeing the patient. I'm diagnosing the patient. I'm treating the patient. I'm following up with the patient. That signature isn't following up with the patient. I am. I'm doing that work. I'm referring them as they need to be referred, so I'm doing all the appropriate things,” said Nelson.

More than 20 states have already allowed full practice authority for nurse practitioners, but local doctors say it’s a bad idea.

“The biggest problem is their education and training. They are not MDs and DOs and to allow them to do that is going to increase the level of care, the quality of care that we would like to provide to the citizens of Oklahoma,” said Dr. Art Rousseau.

He says the bill could allow for prescription drug abuse.

“Many times the nurse practitioner is out writing prescriptions they shouldn't be writing, not having the education and training to know sometimes when to prescribe one medication and not another,” he said.

“That is not true,” says Carlton. “We will still not be able to prescribe the schedule two, schedule one narcotics that we currently cannot prescribe. That doesn’t change that,” she said.

Nurse practitioners say the bill is currently being held up in the Appropriations and Budget Subcommittee on Health. It’s chaired by Rep. Doug Cox, a physician.

“It’s my understanding the chairman has decided not to hear the bill. If that has changed, no one has let me know. If this is not heard in the next two weeks in committee, it’s dead,” said Rep. Jon Echols, the bill's author.


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