- Beginning on Tuesday, nurse practitioners in Kentucky will be able to prescribe routine medications without the oversight of a physician provided they have completed a four-year collaboration with a doctor.
- The legislation, which passed earlier this year, is in response to a growing physician shortage in the state—a shortage that mirrors a nation-wide trend.
- The law established a six-member committee that creates a list of physicians willing to oversee a nurse for the four-year period. If the NP can't find someone from the list within 30 days, the committee will provide a physician.
According to the bill's main sponsor, state senator Paul Hornback, the major challenge to the legislation was identifying physicians who were willing to enter into this kind of agreement with a nurse practitioner. Although Hornback said that the four-year rule was appropriate because it mimicked the concept of a medical residency period, many physicians are divided over the issue of expanding NPs' autonomy.
"The concern is that you don’t know what you don’t know," said Robert McLean, an internist in New Haven, Conn.
Regulations vary from state to state. 19 states require NPs to have a collaborative arrangement with a physician for their entire careers, and 12 require nurses be supervised by doctors, with NPs prescribing through the doctors.
The 19 remaining states, plus D.C., allow NPs to practice independently of a physician. Seven states—Connecticut, Minnesota, Vermont, Nevada, Maine, Colorado and now Kentucky—require NPs to spend a set amount of time in an arrangement with a physician before they are allowed to prescribe independently.