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Pennsylvania Medical Society’s opposition to Bartolotta bill disappointing

By Melany Chrash 3 min read

As a nurse practitioner working in Greene and Fayette County and one who actually makes house calls to my patients, I am grateful for the bill sponsored by Senator Bartolotta. I am happy to say that this reform is endorsed by AARP Pennsylvania, the PA Rural Health Association, the Hospital and Health System Association of PA, and many more. Even the Federal Trade Commission “has consistently urged state legislators to avoid imposing restrictions on APRN scope of practice — expert bodies have concluded that APRNs are safe and effective as independent providers of many health care services — mandatory physician supervision may not be justified.” It is important to remember that this reform has support from lawmakers whose districts support President Trump as well as Hillary Clinton.

I was disappointed to read that the Pennsylvania Medical Society (PMS) continues to stand alone in opposition to common sense reform to improve health care (Letter to the Editor: Public says no to ‘SkimpCare’ bill in April 4 edition). Physician trade associations are the only — I repeat, only — groups that oppose this common sense change. PMS is at odds with the National Academy of Medicine, which issued a major report in support of this reform. The FTC has raised concerns that a physician group has the ability to restrict access of nurse practitioners to the health care market and therefore deny consumers competitive health care. The PMS has strong financial incentive to oppose the independent practice of nurse practitioners.

The bill would eliminate the government mandate for nurse practitioners (APRNs) to have business contracts with physicians. Some nurse practitioners pay some physicians thousands of dollars for these contracts or are employed by physicians because they cannot practice without a collaborative agreement.

Under the reform, every nurse practitioner would need to have a Master’s or doctorate, earn national board certification in their area of expertise, and secure a license from the PA Board of Nursing. Every nurse practitioner would be required to prove they know how and when to collaborate with physicians (and pharmacists, and specialists, etc) as part of their certification.

By cutting expensive red tape, the reform makes it easier for nurse practitioners to serve patients. When more nurse practitioners see more patients, it’s easier to catch little health problems before they become big ones. The result is better, more affordable health care for everybody and a healthier Pennsylvania.

Unfortunately, the Medical Society refuses to collaborate in support of this proven reform to help patients. Most offensive of all, they knowingly mislead the public by claiming their opposition is about patient safety. In fact the opposite is true: this reform has proven over and over again to increase quality, expand access, improve patient satisfaction and lower costs. Their objections have more to do with their pocket books than anything else.

Twenty-two states already have the reform. Every medical society in every one of the 22 states that enacted it predicted doom and gloom. Every time, they’ve been proven wrong. When the political dust settled, overwhelming evidence showed that the reform worked and patients received quality care from nurse practitioners.

Pennsylvania faces a health care shortage, especially for seniors and rural communities. It’s time to embrace reform and offer a polite ‘thanks, but no thanks,’ to those who say the status quo is good enough. We need to improve the health of Pennsylvania now and Nurse Practitioners are very capable of doing just that!

Melany Chrash, MSN, APN-BC, PHCNS-BC, PN, Uniontown, Fayette County, Assistant Professor of Nursing at Waynesburg University, Nurse Practitioner, Amedisys, Inc.

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