CLEAR

New research on nurse practitioner scope of practice

Research presented at the American Enterprise Institute focused on shortages in primary care and the effect of nurse practitioners scope of practice restrictions. The study findings, presented by Dr. Peter Buerhaus, healthcare economist and professor of nursing at Montana State University, show projected growth in the NP workforce, with primary care nurse practitioners more likely than physicians to practice in rural areas. However, the research shows that access to PCNPs is significantly less in states with laws restricting NP's scope of practice. The research also shows that "beneficiaries who received their primary care from NPs consistently received significantly higher-quality care than physicians’ patients in several respects." Regarding the claim that scope of practice restrictions are necessary to protect the public from low-quality providers, "Analysis of different classifications of state-level scope-of -practice restrictions provided no evidence that Medicare beneficiaries living in states that imposed restrictions received better-quality care."

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US: Congress considers opioid bill with expanded buprenorphine prescription authority

An opioid bill currently under consideration by both the US House and Senate would, among other measures, permanently allow nurse practitioners and physician assistants to prescribe the anti-addiction medication buprenorphine, upon undergoing extra training and receiving a special license. The bill would also allow nurse anesthetists, nurse midwives and clinical nurse specialists such prescription authority for the next five years.

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Malta considers legal profession regulation

The Attorney General in Malta is reviewing a bill to regulate the legal profession. The proposed bill defines what legal services can be offered exclusively by lawyers and what services can be offered by other professionals who are regulated by a different authority. The bill establishes regulation for law forms and the requirement that all lawyers are members of the Chamber of Advocates. The Chamber of Advocates will issue an annual practicing certificate. Continuing professional development requirements are also included in the bill. Upon review, the bill will be passed on to the Cabinet.

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Complaints and lawsuits filed against online teeth aligner companies

Several online companies have entered the teeth alignment industry by offering at-home teeth impression kits and mail-order purchase of plastic aligners. The American Association of Orthodontists has filed complaints against the companies with dental boards in 36 states, and the American Dental Association has issued a resolution urging consumers not to use such services. Those speaking out against the companies cite the potential for complications if treatment and follow-up care is not provided by an orthodontist. The Georgia Board of Dentistry recently passed a rule requiring a licensed dentist to be present when 3D dental scans are taken, effectively preventing the online companies from setting up shops in Georgia.

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Research study on scope of practice and burnout

A research study on "Burnout and Scope of Practice in New Family Physicians" concluded that family physicians who practice a broader scope of practice at the beginning of their careers may be less likely to experience burnout. The research was conducted by researchers with the American Board of Family Medicine and the University of Washington Family Medicine Residency Network. The study's ample included physicians providing outpatient continuity care. The study concluded that "family physicians who practice in more locations and performed a greater variety of procedures/clinical areas were less likely to report feeling burned out" with the strongest associations for those practicing obstetrics and inpatient medicine.

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NCSBN requested to revise APRN Compact

The American Academy of Family Physicians and a group of other professional medical organizations and state medical associations have issued a request to the National Council of State Boards of Nursing to revise the Advanced Practice Registered Nurse Compact by removing language that grants prescriptive authority to APRNs and allows them to practice without supervision or collaboration of a physician. The APRN Compact was approved in 2015 and will be implemented once ten states have enacted it. Currently, three states have enacted APRN Compact legislation.

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Florida: court case on dry needling scope of practice

The Florida State Oriental Medical Association has filed a challenge in court asking an administrative judge to block a rule proposed by the Florida Board of Physical Therapists to allow physical therapists to perform dry needling. The challenge asserts that the proposed rule is essentially an illegal expansion of the scope of practice of PTs. The Board of Physical Therapy's rule would require additional training and an in-person examination before granting PTs authority to perform dry needling, which they say does fall under PTs' scope of practice to use apparatuses and equipment on their patients.

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States easing restrictions for physician assistants

Many states have recently changed regulations to allow physician assistants to work more collaboratively with physicians in team-based care. New Mexico and Tennessee have changed regulations to refer to "collaboration" rather than physician "supervision" of physician assistants. Thirty-eight states and the District of Columbia now allow scope of practice to be determined at the doctor's practice site. Many of the changes are in response to a shift to a team-based approach to healthcare delivery. More than 40 states have also implemented full prescriptive authority to physician assistants.

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Virginia: new law regarding hair braiding

A new law in Virginia goes into effect July 1 to clarify that hair braiding is not the practice of cosmetology and does not require a license. The Virginia Department of Professional and Occupational Regulation had deregulated hair braiding in 2012, and the deregulation will now be Virginia law. But some cosmetology instructors are still arguing that braiders do need formal training for this specialized field to avoid injuries to the scalp and hair.

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Draft guidelines published for office-based primary care procedures

The Project on Facility Guidelines for the Safe Performance of Primary Care and Gynecology Procedures in Offices and Clinics has published a draft set of guidelines open for public comment through May 13. The project was undertaken by the American College of Obstetricians and Gynecologists and the National Partnership for Women & Families, with the American Academy of Family Physicians, the American College of Physicians, the American College of Nurse-Midwives, Nurse Practitioners in Women's Health, and the Society of Family Planning. The group reviewed evidence and current clinical practice in six domains: emergency preparedness, biological material handling, physical plant specifications, clinician qualifications beyond licensing and competency, other policies and procedures, and facility accreditation and licensing. The guidelines' goal is to "articulate evidence-informed guidelines that will further health care quality, safety, affordability and patient experience without imposing unjustified burdens on patients' access to care or on clinicians' ability to provide care within their scope of practice."

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