Health Watch

Jul 10, 2012 10:26 PM

Kentucky's Non-physicians Seek Greater Independence

COLUMBIA, Ky. (AP) - Some nurse practitioners are seeking greater independence in how they are allowed to provide medical care, especially in rural areas that don't have enough doctors.

Current state law requires nurse practitioners to have a "collaborative agreement" with a doctor in order to treat patients. Although many physicians find the agreement necessary, nurse practitioners call it an impediment.

Beth Partin and Julie Gaskins run a mother-daughter health practice in Columbia that provides primary care with only nurse practitioners to hundreds of patients in the rural community. Partin told The Courier-Journal ( that nurse practitioners should be granted more independence to treat patients in Kentucky, which has a shortage of health professionals in almost half its counties, according to the federal government.

Partin said the agreements "put practices in jeopardy" if a physician moves, dies or charges a large fee for the agreement.

"We've outgrown that model," she said. "If we weren't there, patients wouldn't be receiving care, because there wouldn't be enough doctors."

Other non-physicians are also seeking more independence in treating patients, include nurse anesthetists and optometrists.

Kentucky Medical Association President Dr. Shawn Jones, said he opposes allowing non-physicians more independence in treating patients.

"Physicians are more well-qualified and well-prepared to practice medicine than any other group," Jones said. "I don't think most physicians are concerned about our livelihoods. We're worried about the safety of patients."

People being treated have different views.

Carey Stevens, 24, of Danville, said it made her feel better that a physician was in charge of her anesthesia during her gall bladder and kidney stone surgeries.

"I do feel more comfortable having a doctor," she said. "You never know what could happen."

But others, including Nancy King of Columbia, say they prefer getting care from a nurse.

"She actually takes time to listen. A lot of doctors don't," said King, 49, who is one of Partin's patients. "Nothing should hold (nurses) back."

Experts say an increase of newly insured patients under the federal health care reform law could sway the debate.

"We don't have enough doctors to go around," said Julia Paradise, an associate director of the Kaiser Commission on Medicaid and the Uninsured in Washington, D.C. "That's the reality. . And we have other people who are highly trained to provide primary care."

(Copyright 2012 The Associated Press. All rights reserved.)


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