NEW ORLEANS — The demand for health care is growing fast and some communities across the state, whether rural or urban, don't have the same access to doctors that others have.
That's where providers like nurse practitioners come in.
They're not doctors, but can provide more care than a registered nurse, while under the oversight of a doctor. When the pandemic started, Governor Edwards temporarily suspended that oversight requirement. Now a bill in the state legislature, would make the change permanent.
To understand each side of the debate, we turn to the president of the Louisiana Association of Nurse Practitioners, and the President of the Louisiana State Medical Society.
In favor of the bill, nurse practitioners want to provide health care, within their scope of training, without being required to pay a doctor who agrees to be available if needed.
“They (doctors) make out like this collaborative practice agreement provides this safety net. It does not,” explained Dr. Kathy Baldridge, who has a doctorate of nursing practice and is a board-certified family nurse practitioner. She is a Fellow of the American Association of Nurse Practitioners and the President of the Louisiana Association of Nurse Practitioners.
Against the bill are those with a medical degree. Doctors say nurse practitioners would be practicing medicine without the oversight of the State Board of Medical Examiners.
“I have seen really dangerous practices coming from nurse practitioners that haven't had the proper training, but yet making a lot of money from it,” said Obstetrician and Gynecologist Dr. Katherine Williams, President of the Louisiana State Medical Society. It is the state’s largest society of doctors representing 8,000 physicians.
Nurse practitioners say they are accountable to the Board of Nursing and their patients. They say this bill is about access, especially in rural parishes. Their clinics are often the only place people on Medicaid and Medicare can get health care. And there are fewer doctors available to collaborate with them. She sited one example.
“Something happens to his physician, all five clinics shut down. That means that all the patients, which is almost the entire parish, doesn't have access to care,” said nurse practitioner Dr. Baldridge.
The doctors say nurse practitioners were not willing to restrict the bill to rural areas.
“In fact in Louisiana, about 87 percent of nurse practitioners are in the urban communities, and a lot of times they will come in the urban communities and practice in ways they were not trained for,” said Dr. Williams.
Nurse practitioners say more than two dozen other states have enacted this type of legislation without patient safety problems.
“In Louisiana, we are fiftieth in health outcomes. We need all boots on the ground,” said nurse practitioner Dr. Baldridge.
The doctors say big hospital corporations are replacing MDs with nurse practitioners to save money.
“The fact is med school matters. And this bill does not protect the public and it's very concerning for physicians,” said Dr. Williams.
The bill passed in the full House, and after amendments, it passed in the Senate Health and Welfare Committee as well. I
It could come up for a vote this week on the Senate floor.