Archives     Advertise     Editorial Calendar     Subscribe     Contact Us    


We Need More Collaboration in Healthcare, Not Less


 
JOHN W. HALE, JR., MD

Tennessee Public Chapter 1046 created an equally balanced task force of advanced practice nurses and practicing physicians to "make recommendations to the general assembly for the improvement of Tennessee residents' health by providing access to quality and cost effective care." The group first met in June 2016 and, after several meetings and other deliberations, will issue a few recommendations to the General Assembly for legislators to consider in 2017.

One thing the task force agreed on is that there are physicians and nurses in our state who are not following protocols for collaboration. These providers, regardless of the letters beside their names, are jeopardizing patient safety and quality of care and contributing to our state's prescription drug abuse epidemic. We need to remove "in name only" physician/APRN relationships and do a better job enforcing rules that are in most cases working well.

To achieve this, we need to increase communication and collaboration between the Board of Medical Examiners, Board of Osteopathic Medical Examination and the Board of Nursing. We need to increase funding to give these boards the lawyers, investigators and other resources they need to identify and prosecute bad actors. And we need to make it easier for APRNs to establish and maintain a collaborative relationship with a physician.

What we cannot do, however, is allow APRNs to practice without a collaborative relationship with a physician.

Doctors and APRNs serving on the task force struggled to find consensus in discussions that were masked as increasing patient access to care, but in fact centered on independent practice for APRNs in Tennessee.

Sometimes called "full practice authority," independent practice means giving APRNs the legal authority to treat and diagnose patients, prescribe medication, order tests, manage chronic illnesses and deliver other healthcare services, including those currently reserved for physicians, without physician supervision, oversight or collaboration. Current state laws require APRNs to establish and maintain relationships with physicians to make sure safe, appropriate care is delivered on a consistent basis, including the prescription of opioids and other controlled substances. Nothing in current state law prevents APRNs from performing APRN duties.

APRNs on the task force - mostly academicians - were direct and unwavering in their efforts to modify or remove mandatory collaboration laws so they can practice beyond the scope of their education and training.

I, along with my physician colleagues in the Tennessee Medical Association, will not support nurse independent practice because APRNs and physicians simply don't have a comparable level of education, training or experience, even in primary care. There is too much at stake with patient safety and quality of care to remove physician collaboration.

I applaud Sen. Becky Massey of Knoxville for her efforts toward compromise. Sen. Massey sponsored a bill that would have created APRN independent practice in Tennessee but ultimately created the task force and facilitated the group meetings and email discussions between participants.

I also appreciate the opportunity to serve alongside my physician colleagues, APRNs and state lawmakers in important discussions about how to improve healthcare access, quality and safety for patients in Tennessee.

We need more collaboration in healthcare and more integrated delivery teams, not more silos.


John W. Hale, Jr., MD is a family physician in Union City, Tenn. He is immediate past president of the Tennessee Medical Association and served as co-chair of the legislative task force on scope of practice.

For the past two years, TMA has advocated for a team-based approach to healthcare delivery that strengthens relationships between healthcare providers, including doctors, APRNs, PAs and others. The organization's position is clearly laid out at tnmed.org/teambasedcare.

 
Share:

Related Articles:


Recent Articles

Integrating AI in Healthcare

Technology has advanced to a point where AI in healthcare is increasingly common. Now the challenge is utilizing data in a way that is not only predictive but also prescriptive to improve health and outcomes.

Read More

AMA Advances New Principles to Put AI into Practice

AHIP isn't the only national organization focused on how AI might be effectively deployed to improve patient engagement, care and interaction with the broader healthcare system.

Read More

State of Technology

Nashville HIT leaders address challenges, accomplishments of the region's thriving healthcare IT market.

Read More

Helping Children and Athletes Breathe Easier

Experiencing shortness of breath during exercise can be extremely distressing, particularly when it occurs in a child, teen or young adult.

Read More

PHYSICIAN SPOTLIGHT: Between Medicine and Technology

When it comes to rolling out new systems, Neal Patel, MD, said listening to users and understanding concerns are critical to success.

Read More

Navigating the Risks of New Healthcare Technologies

New technologies in healthcare hold great promise, but with that promise come risks that must be considered and addressed.

Read More

Tech Talk

Recent news of note in Middle Tennessee's health tech sector.

Read More

Enhancing Access to Care through Technology

Innovative technology allows patients, health plans to schedule appointments online.

Read More

Reimaging Residency

A joint project between Vanderbilt and Ole Miss was one of eight selected by the American Medical Association to reimagine residency programming.

Read More

Tips & Traps: Expert Insights from NMGMA Leadership

NMGMA's president and president-elect share insights borne of experience to help practice managers enhance success.

Read More

Email Print
 
 

 

 


Tags:
Advanced Practice Registered Nurses, APRN, Carole Myers, Healing Arts Scope of Practice Task Force, John Hale, Physician Supervision, Scope of Practice, Tennessee Medical Association, Tennessee Nurses Association, TMA, TNA
Powered by Bondware
News Publishing Software

The browser you are using is outdated!

You may not be getting all you can out of your browsing experience
and may be open to security risks!

Consider upgrading to the latest version of your browser or choose on below: