Tanner and Marshall Lend Strong Voice to MAFP Position in APRN Scope of Practice Debate



MAFP President Dr. Tina L. Tanner (Hesperia) and MAFP member Dr. Mary Marshall (Grand Blanc) testified in front of the Michigan Senate Health Policy Committee March 10, speaking out in opposition to Senate Bill 68, as written.

The bill mirrors Senate Bill 2 from the 2013-14 legislative session, and was introduced by Senator Mike Shirkey (R-Clarklake), who is also the committee chair. This week was the second in a series of hearings Shirkey is holding on the bill.

MAFP President Tina Tanner, MD, and MAFP member Mary Marshall, MD, RN, lend a strong voice to MAFP opposition to the bill (SB 68) as written.

Tanner opened testimony, outlining the MAFP position on SB 68.

"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…the bill would, in practice, expand the scope of practice of APRNs, allowing them to perform critical acts and functions independent of a physician.”

Tanner then outlined specific concerns in the bill, including unrestricted prescriptive authority granted to APRNs, specifically with respect to Schedule II and III controlled substances. Due to the highly addictive nature of these substances, Tanner asserted that “in the interest of patient safety and public health, prescribing privileges pertaining to these drugs must require an established relationship with a physician.”

She went on to say, “In his State of the State address, Governor Snyder highlighted the curbing of prescription drug abuse as a key goal for his administration. We would argue that opening up unrestricted prescribing privileges to an entirely new population runs directly counter to that goal.”

During testimony, Tanner and Marshall also challenged the assertion that granting independent practice to APRNs would help alleviate pressures related to access to care, particularly in medically underserved areas. They referenced data from other states with independent practice that suggest APRNs are no more or less likely than physicians to go into these areas.

Instead of focusing efforts to expand responsibilities for one provider group, Tanner and Marshall urged legislators to look at the bigger picture.

“We need to consider leveraging existing tools and incentive programs, like the primary care loan repayment program; reforming the way we fund Graduate Medical Education; rethinking the way we recruit and educate aspiring physicians in our medical schools; and improving coordination and communication across the continuum of care through the use of provider teams,” Tanner told committee members.

The committee heard testimony from supporting and opposing sides of the debate in the first two hearings, March 3 and March 10. Another hearing is scheduled for next week, but the prospect of a vote is still unclear.

While opposed to SB 68, as written, MAFP continues to actively engage in discussions with Shirkey, as well as policymakers and staff in both the House and the Senate, to find resolution to this long-standing debate.


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