by Brenée Goforth
Communications Associate, John Locke Foundation
This week, Carolina Journal’s Julie Havlak wrote an article on the effects of scope-of-practice restrictions on the supply of health care professionals for geriatric patients. Havlak writes:
Thousands of elderly patients lost their health care provider, and nurse practitioner Michelle Schmerge had to watch them go.
When her supervising physician decided to retire, she couldn’t find a replacement. As a nurse practitioner in North Carolina, Schmerge couldn’t practice without a doctor’s guidance, but geriatric doctors are in short supply.
That’s why Schmerge now supports Senate Bill 143, the SAVE Act, which was introduced in the General Assembly in 2019. The bill would lift state requirements that force advanced nurse practitioners — like Schmerge — to operate under physician supervision. If passed, the bill would allow Schmerge to keep her patients, she told Carolina Journal.
Schmerge argues that nurse practitioners could fill in the gaps — if they didn’t have to pay thousands of dollars for supervision. Like other nurse practitioners, she says that physician oversight is often limited to a few signatures and two visits per year. But S.B. 143 faces serious pushback from physician organizations that argue geriatric care will atrophy unless education and payments are changed.
The bill is not guaranteed to pass. Havlak writes:
Similar reforms flopped in California after lobbyists for doctors waged a bitter campaign against freeing nurses from physician supervision. They drummed up fears for patient safety, which nurses characterized as a blatant disguise for physicians’ desire to keep collecting money from nurses.
Many states, however, have managed to pass scope-of-practice reforms for Advanced Practice Nurse Practitioners. Havlak writes:
Nurse practitioners like Schmerge say they could help meet patient demand if North Carolina lifted cumbersome regulations. They have won full practice authority in 22 states. If passed in North Carolina, S.B. 143 could be added to their list of victories.