Wednesday, March 11, 2020

Re AB 890 (Wood): Full Practice Authority for Nurse Practitioners 

AB 890, authored by Assemblyman Wood, DDS, is reportedly designed to fill a gap in access to healthcare. The underlying problem is that there are not enough physicians especially for injured workers (these patients are seen via workers comp). While attempts are made to train more physicians, this effort is not seen as adequate. Wood's solution is to allow Nurse Practitioners (NP) to fill the gap.The claim is made that NPs will gravitate to underserved areas and work for less remuneration than their physician colleagues. 

Nothing, however, in the current written legislation guarantees that NPs will gravitate to underserved areas or stay there if they do -- the NPs will not be obliged to give up chances for employment in better served areas or to charge less for services that the legislatue has deemed equivalent. Pay parity for the same job or equivalent services is to be expected especially by NPs who are properly organized. 

Unfortunately, The bill has verbiage harmful to physicians, patients, and hospital medical staffs. 

Item # 1: The bill says that "a nurse practitioner shall be eligible to serve on medical staff and hopital committees." So much for the exquisite education, training, and preparation that have to date been required of physicians. 

Item # 2: under Section 2637.101 it is stated that "there is in the Department of Consumer Affairs the Advanced Practice Registered Nursing Board consisting of nine (underlining added) members."

Item # 3: this item is under Section 2637, 103. It states that "commencing January 1, 2026, four (underlining added) members of the board shall be nurse practioners licensed under this chapter. 

Item # 4: Three members of the board shall be physicians and surgeons licensed by the Medical Board of California or by the Osteopathic Board of California and that "at least one of the physician and surgeon members shall (underlining added) work closely with a nurse practitioner" and that "the remaining physician and surgeon members shall focus on primary care in their practice." 

Item # 5: Two members of the board shall represent the public at large and shall not be licensed under any board under this division or any board referred to in Section 1000 3600."

Conclusion can be drawn with reasonable accuracy that the chief purpose of this bill is to change practice standards such that medical and/or osteopathic professional standards are no longer required for medical practice. 

Further conclusion is that AB 890 shows how a bill ostensibly designed to increase access to care evolved into legislation pitting one group's fiscal and professional prerogatives against another group's fiscal and professional percs. 

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