Texas Nurses Push for Greater Practice Autonomy

Nurses in Texas are lobbying to broaden their authority to practice without physician oversight, reports Politico Pro . Nearly half of the 50 states and the Veterans Administration allow nurses with advanced degrees to practice without a contract with a physician to review their cases, while in December the U.S. Department of Health and Human Services recommended expanding the ability of non-physician providers to treat beneficiaries. Advocates in Texas see improved odds of such bills passing, amid growing doctor shortages and healthcare budget austerity. Rep. Stephanie Klick (R-Texas) says she intends to file a bill allowing nurse practitioners, nurse midwifes, and clinical nurse specialists to practice independently after an interval of physician oversight, and another permitting beneficiaries to see a physical therapist without a physician referral. An earlier stipulation that nurses must have an agreement with a physician in order to diagnose conditions and prescribe medication has met resistance from nurses, who say these pacts are expensive and onerous. Nearly 20 percent of nurses pay an often-high fee to doctors for the agreements. They also refute claims from physicians that with the growth of online nursing degree programs, many nurses are unqualified to practice independently.