Tennessee state laws require APRNs to collaborate with physicians because doctors have more education, training and experience than any other healthcare professional, including APRNs. Each team member plays a vital role and should be able to work to the fullest extent of his or her education and training, but team members are not equivalent or interchangeable. Changing state laws to allow APRNs to sever professional relationships with physicians and practice beyond the scope of their education, training and experience would essentially be giving them licenses to practice medicine (what doctors do).
This bill would threaten patient safety and quality of care and create the risk for missed diagnoses, increased opioid prescriptions, and/or overutilization of services (redundant tests, unnecessary visits and referrals, etc.), which increase overall healthcare costs.
This bill would create more fragmentation in healthcare when the entire industry is moving in the opposite direction. We need more integrated and coordinated healthcare delivery in Tennessee, not more silos.
Patient-centered, physician-led care is the best way to increase healthcare access without compromising patient safety or quality of care.
• Data shows that primary care physicians and APRNs tend to work in the same geographic areas in Tennessee and other states, regardless of the level of autonomy allowed by state policies. APRNs are no more likely to open or maintain rural practices than primary care physicians for the same economic reasons.
• The emergence of telehealth allows for more frequent and effective collaboration between physicians and the rest of the healthcare team despite geographic challenges.
• Patients prefer to have a physician involved in their care and deserve access to safe, high-quality care led by a physician, no matter where the patient lives.
• APRNs claim that they can fill a healthcare gap in Tennessee communities where hospitals have closed is nonsensical. Primary care offices staffed with APRNs is not the same as physician-led emergency and specialized care access via hospitals.
• APRNs will tell you they were allowed to practice without collaborating with a physician during the COVID-19 pandemic. However, Governor Lee’s Executive Order allowing the waiver of the collaboration requirement was only a few weeks and during the same period of time that many practices were shut down as all elected procedures were halted.
• TMA has made numerous offers to modernize oversight rules but the nurses and physician assistants have opposed them.