MAFP Offers Testimony in House Committee on Scope of Practice for APRNs

MAFP President Dr. Tina L. Tanner (Montague) testified in front of the Michigan House Health Policy Committee Sept. 9, speaking out in opposition to Senate Bill 2 as written. Dr. Tanner was the first called up to testify following the bill's sponsor, Senator Mark Jansen (R-Gaines Township), who said allowing nurses to do more would help with the physician shortage.

"APRNs are not here today to ask for incentive dollars to go and take care of people," Jansen said. "What they are trying to do is provide a level of health care for which they have been trained."

Joined by MAFP member and longtime friend Dr. Mary Marshall (Grand Blanc), Dr. Tanner spoke on behalf of MAFP.

"We view the increasing variety of situations in which APRNs are utilized as a strong positive and support appropriately defining their scope and licensure in the Public Health Code," she said. "However, this bill, as written, falls short of accomplishing these objectives. Instead, it would expand the scope of practice of APRNs to allow them to practice independent of a physician, erecting barriers to the communication and collaboration deemed essential to the provision of quality health care."

During testimony, Dr. Tanner outlined specific changes to SB 2 that would, among other things, provide for a statutory structure whereby a meaningful, communicative relationship can exist between a nurse practitioner and a physician.

In addition, Dr. Tanner said the bill puts patient safety at risk by not defining the number of Continuing Education (CE) hours required of an APRN. According to the Institute of Medicine report on the future of nursing, nurse practitioners are only required to complete 2-4 years of graduate-level education for a total of 500-720 patient care hours. Contrast this with the 12,000-16,000 hours required of physicians.

In a letter submitted to Committee Chairwoman Gail Haines (R-Lake Angelus) and members of the committee, MAFP calls for a requirement that APRNs practice within a patient care team; continuing medical education requirements that are more clearly defined; and core curriculum requirements that are supervised by a mentor who may or may not be a physician (but should have at least 8 years of clinical experience).

"As a practicing family physician, I have the opportunity to work with many excellent professionals," Dr. Tanner said. "I have yet to encounter anyone who functioned better in isolation."

MAFP was also asked to submit recommendations to Governor Rick Snyder, senior advisors and others, detailing suggested changes to the bill. Currently, no further hearings on the bill have been scheduled in the House prior to the end-of-the-year adjournment.

For more information about the hearing and MAFP testimony, click here to read the Gongwer article (requires login).