The Florida Legislature passed a bill on Wednesday that would provide Floridians greater access to healthcare, particularly in rural and underserved communities.
The bill (HB 607), sponsored by State Representative Cary Pigman, who is also a trained emergency medicine physician, would remove unnecessary barriers, expanding the roles of registered nurse practitioners and physician assistants to be able to practice medicine to a greater extent without supervision.
The measure, which passed after it was amended by the Senate on Tuesday, allows Advanced Practice Registered Nurses (APRNs) more autonomy to deliver health care for patients during a time where the state is facing problems meeting the demand for health care providers due to an influx in population.
The amended bill, however, was watered-down from its original version, with Senate lawmakers reluctant to fully increase the autonomy for nurses.
Expanding the scope of practice has been a top priority for House Speaker Jose Oliva, who has devoted much of his tenure instituting responsible health care reform and making it more affordable for Floridians. Coming into his final legislative session, Oliva sought to allow nurses to practice freely without any regulation.
While the dialed-back version of Oliva’s magnum opus does increase the capacity to practice, it comes with a caveat: requiring APRNs to take at least 3,000 clinical practice hours in the five years before practicing autonomously, which deviated from what the speaker wanted.
Still, today’s passage drew praise from pro-business leaders around the state. The Florida Chamber, a business advocacy group responsible for protecting Florida’s Constitution from special interest groups, applauded the bill reaching the finish line.
“With 900 new residents moving to Florida each day, and 4.5 million more residents expected to call Florida home by 2030, it’s vital that Floridians have increased access to safe, quality healthcare,” said David Hart, Executive Vice President, Florida Chamber of Commerce
The proposal was an uphill battle for Republicans looking to lower health care costs and allow practitioners to alleviate the state’s crippling demand for practitioners. While many in the field saw the bill as a way to increase the supply of competent health care providers, many doctors and physician groups were extremely vocal in their opposition.
The bill will now head to Governor Ron DeSantis for approval.
What people don’t realize is bills like this open the floodgates for healthcare business interests to fire physicians working in critical care settings and replace them with cheaper (so far) and less-experienced nurse practitioners. In states with FPA it is now common to go to the ED or the hospital and not have access to a physician at all, because there is all-NP staffing.
As a physician, my job is secure. But as a potential patient, mother of patients and daughter of elderly patients, I do not feel good about the prospect of a nurse practitioner rather than a physician being responsible for the life of my child if brought to the ED after a car accident, my elderly parent in the ICU with a heart attack, or me in the hospital with COVID-19.
Also, bills like this do not require NPs to carry malpractice insurance at the same level as physicians are required to. So, if a patient is harmed by NP malpractice, they have much less recourse to seek damages, because the level of coverage a typical NP carries will not be enough to get a plaintiff’s attorney interested in filing a suit.
A slap in the face to those who did the work to practice medicine and devote themselves to patients, especially those who are specialized in Primary Care. You reap what you sow, Dr. Pigman. I assume you and your fellow legislators will now seek out care from non-physician “providers”?
Knowing this was coming down the pike is what made me decide to cancel an interview to work as a Family Practice physician in your state recently.
FYI a lot of places will charge the same amount of money whether you see a nurse or a doctor. So all they’ve done is screw patients out of seeing competent providers for very little savings. Glad I don’t live in Florida for this and many reasons.
All the legislators and Pigman had to do was support the federal bipartisan bill, the Resident Physician Reduction Shortage Act, that would open 15,000 residencies over 5 years. The bill mandates that most of those residencies will be in primary care focused in underserved areas. Nope. Just ignored that and went with nurses who have master’s degrees which Pigman believes somehow compensates for physicians. And for the record, this NP bill DOES NOT mandate NPs have to practice in underserved areas. If they don’t want to they don’t have to. The legislators have given them a license to practice medicine wherever they want, however they want, whenever they want. With no indication of who is going to manage the complications of any mistakes they make due to their lack of medical knowledge. It will the be the same people it has always been, the very physicians/colleagues for whom Pigman has no respect.
If anyone does not recognize that this is a financial move to increase profits, I have a bridge I want to sell you in Timbuktoo.
Y’all need to get off your high horse, and almighty opinion of yourselves. EBP has shown time after time that NP’s provide safe and effective care for patients see examples at the VA, IOM 2010, as well as many states. Furthermore just because the law no longer requires collaborative or supervision of NP’s doesn’t mean all collaboration will stop we all collaborate when it is needed. moreover to a point made above NP are only more expensive when you throw in physician rounding or collaborative agreements you remove that and they can charge less because they can practice for less. Lastly I’ve had poor and great experiences with all types of providers as I’m sure many people have but that doesn’t make one model better than the other just gives more options to people and don’t underestimate the people if they care which profession they see for treatment they will learn about the different services provided and by whom allowing them to seek out those practitioners. but consider this it is our responsibility as providers to teach our patients about the options they have and who can provide those services effectively not to diminish the role of other providers.
Maybe the collaboration should stop. Let independent NP in their respective specialties consult each other :)) since it is safe and it doesn’t matter which “provider” you are right? Why stop here? Let the nurse do surgery too! It should be safe too!! 😀
I hope you did better in science than in English. You’ve set the world record for run-on sentences.