House OKs bill to let nurses practice independent of MDs

Over the strong objections of organized medicine a House health care subcommittee on Wednesday gave the green light to a bill that would allow advanced registered nurse practitioners to work independently from physicians.

The House Innovation Subcommittee debated HB 547 for one hour before passing it by a 9-4 vote and heard from a score of proponents and opponents.

At times the debate teetered on testy.

“Where i grew up the kids played doctor,” said Rep. “Doc” Renuart, who opposed the measure. “And I think where Doctor [Cary] Pigman grew up, they must have played nurse.”

Committee member Rep. Jose Oliva said legislators should not be “alarmed” that the bill would allow advanced registered nurse practitioners to have independent practices. He said that if the opposition from organized medicine was accurate — and care would be less than adequate — the supervisory role doctors have over RNs could be maintained.

“But let’s make it illegal to charge for that supervision, and let’s see how long that motivation would remain,” Oliva said.

Florida Medical Association President and plastic surgeon Alan Pillersdorf said after the meeting that the FMA’s concerns with the measure focused only on quality of care and had nothing to do with money.

“We need to work together. … But It’s always about safety and about getting quality medical care. That’s really what the FMA is about. And we know we get quality  care from nurse practitioners. But just the fact that they clapped at the end, it kind of hurt my feelings because this is not a courtroom where there are winners and losers. We are trying to define things for safety. And to equate it financially is incorrect.”

The bill would allow certain advanced registered nurse practitioners to have independent practices that are registered with the state and not have to practice under the protocol of a physician. The bill lays out what Pigman described as a “pathway to independence.”

Advanced nurse practitioners would be able to practice independently only once they complete a graduate level pharmacology course and had 2,000 clinical nurse practitioner hours within a three-year period immediately preceding the submission of the application.