Nurse practitioners fire first shots in latest battle to achieve independent practice

Tags: news, texas family physician, scope of practice, advocacy, legislature

Nurse practitioners fire first shots in latest battle to achieve independent practice

Nurse practitioners say they know how to solve Texas’ shortage of primary care physicians: give advanced practice nurses the authority to diagnose and prescribe without physician supervision. And they’re telling anyone who’ll listen.

A May 21 story in the Texas Tribune, “Nurse Practitioners Want Less Doctor Oversight,” is just one of several recent articles describing the coming battle over scope of practice that is certain to occupy much of TAFP’s advocacy efforts during next year’s 82nd Texas Legislature. The Tribune article pits several claims by nurse practitioner organizations against the position of TAFP and the Texas Medical Association that in the interest of patient safety and the delivery of high-quality medical care, state regulations should continue to foster the collaborative model of care in which physicians delegate authority to mid-level providers.

In the story, Lynda Woolbert, executive director of the Coalition for Nurses in Advanced Practice, argues that lawmakers should grant independent practice to nurse practitioners to help address the shortage of primary care physicians, particularly in rural areas.

“Patients need help managing chronic illnesses; they need well-child exams—all things that aren’t physicians’ strongest suits,” Woolbert said.

The CBS TV news affiliate in Austin ran a similar story on the evening news the following week, and an Associated Press story in April listed Texas as one of 28 states considering the expansion of nurse practitioners’ scope of practice.

“This is the first in what will be a long, sustained effort by the nurse practitioners to achieve the independent practice of medicine,” said TAFP CEO Tom Banning.

Marie-Elizabeth Ramas, M.D., a third-year resident at Lone Star Family Medicine Residency Program in Conroe, Texas, was awarded one of two James Martin, M.D. Scholarships from the TAFP Foundation. Ramas traveled to Austin in June to research scope of practice, meet with numerous lawmakers at the Capitol, and gather materials that will help our legislative team craft a policy brief on this issue to prepare for the upcoming legislative session.

As the Academy prepares for what is sure to be a challenging session, your support and your input is needed to help explain the differences between family physicians and nurse practitioners in their medical knowledge, their qualifications to treat patients, their educational requirements, and the quality of care they deliver.

Since this story’s original publication in TAFP’s QuickInfo e-newsletter on May 27, TAFP has received many anecdotes from family physicians around the state that will help build our case for the value of family medicine. But we could always use more. TAFP encourages physicians to continue sending TAFP your thoughts and any examples from your practice that could help illustrate the differences between a family physician and a nurse practitioner. Send e-mails to Jonathan Nelson at