NCMS President, Docia Hickey, MD testified before the Joint Legislative Oversight Committee on Health and Human Services (JLOC HHS) on Tuesday to reiterate the importance of physician supervision of Advanced Practice Registered Nurses (APRN) including Nurse Practitioners (NP), Certified Registered Nurse Anesthetists (CRNA) and Certified Nurse Midwives (CNM). Dr. Hickey pointed out the important role that physicians play as extensions of the state to allow for APRNs to practice to the fullest extent of their individualized training and experience.
Dr. Hickey, a native North Carolinian, described her own personal journey from growing up in a rural community to practicing as a neonatologist in Charlotte. She addressed questions from committee members concerned about access to health care in rural communities and pointed out that APRNs are dispersed in similar patterns to their physician counterparts across North Carolina. She also pointed out the fact that NPs are moving in greater numbers towards specialization and away from primary care while primary care is the major need in rural communities.
Additionally, Dr. Hickey addressed the rural economic benefits and outcomes of physicians compared to APRNs. While studies show that APRN independent practice would result in increased economic impact, even a modest increase in the number of physicians would have significantly greater impact on North Carolina. The NCMS believes it is necessary to address the core reasons why our population is moving out of rural areas in order to attract all types of professional and services to those areas.
The more than 10,000 hours of clinical training physicians have makes them uniquely qualified to provide this service on behalf of the State. Supervision gives a statutory structure to the team-based care model that has been shown to be successful in NC. As we move to more value-based arrangements of care delivery, those teams are going to be even more important. NC physicians stand ready to assist the State in that transformation.
The best model for advanced level practitioners is a collaboration with a supervising physician. Our patients need for all of us to be working together to meet the healthcare needs of a widely dispersed population. Midlevels benefit through the mentorship with a physician and the coverage by the physician’s liability insurance policy.
Please keep up the fight outlined so well by Dr Hickey.
Chuck Willson MD