The American Congress of Obstetricians and Gynecologists (ACOG) opposes this bill which would allow nurse practitioners to practice without a collaborative agreement with a physician.
According to the Robert Wood Johnson Foundation (RWJF), 30 states currently require physician oversight/authority of nurse practitioners to prescribe medications and only 10 do not require such oversight or authority. [1] This collaborative relationship ensures the continuity of care between the patient and his/her medical team.
In the absence of a written agreement there is no indication how collaboration between a nurse practitioner and a physician would occur and as a result, offers no effective patient plan should an emergency situation arise. A written collaborative agreement delegates clear responsibilities for both parties and places patients first and foremost. Optimal patient care is afforded to patients when communication occurs between all members of the clinical team.
Furthermore, nurse practitioner education is not nearly as extensive as that of a physician. The American Medical Association (AMA) indicates that in many cases, areas of nurse practitioner specialization are considered sub-specialties for physicians. Physicians who sub-specialize in a particular area of medicine are required to complete additional fellowship training that extends far beyond their standard medical residency training. Each medical specialty and sub-specialty is represented by a corresponding ABMS member board, each of which administers one national, standardized certification examination for all physicians in each specialty to ensure a minimum level of medical knowledge and competency. [2] Therefore, the extensive training and specialization physicians undertake throughout their careers uniquely qualify them to tend to specific patient needs and to delegate responsibility to a collaborating nurse practitioner under their purview accordingly.
It is for these reasons that ACOG District II opposes S.3289/A.5308.
June 19, 2012
The American Congress of Obstetricians and Gynecologists, District II (ACOG) represents the board certified obstetrician-gynecologists in the state who deliver health care to New York’s women. Our Albany office offers the New York State Legislature its resources as a scientific and educational organization dedicated to quality health care for women. If you have questions on this or any other state legislative proposal, please contact our office at 518-436-3461.
[1] Center to Champion Nursing in America. “Oversight Requirements and Prescriptive Authority by State.” http://championnursing.org/sites/default/files/20090713scopeofpracticemap.pdf. Accessed April 28, 2010.
[2] American Medical Association. “AMA Scope of Practice Series: Nurse Practitioners.” October 2009. http://www. npsearch.org/AANPCMS2/publicpages/08-0424%20SOP%20Nurse%20Revised%2010-09.pdf. Accessed April 27, 2010.