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Letter To The Editor: Dr. Chris Achee – Independent practice of nurse practitioners

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Dear Editor,

Senate Bill 187, by Senator Barrow, would unwisely allow the independent practice of nurse practitioners (NPs). I offer the reader some background information about myself, not to boast, but to provide some baseline credibility. I am a 43 year-old board certified Family Medicine physician who practices in Jennings, LA and willingly collaborates with a dedicated nurse practitioner in an underserved community in Jeff Davis parish. I graduated LSU medical school in 4 years and completed 3 years of residency training. Along the way, I passed 3 separate national licensure exams and then passed a national board certification exam in Family Medicine. I have subsequently recertified with my board by passing this test again 3 years ago. I have spent more than 20,000 hours in post-college didactic and clinical education.

For the last several years, NPs in Louisiana have attempted to obtain autonomy to practice medicine independent of physician oversight. NPs are valuable to the healthcare team, but should not be given unrestricted autonomy to practice medicine. A family nurse practitioner with a doctorate degree has received around 5,000 hours of pre-clinical and clinical training and has passed a single licensing exam administered by the American Academy of Nurse Practitioners.

Furthermore, allowing independent NPs removes the oversight of the Louisiana State Board of Medical Examiners who oversees the licensure of every type of medical practitioner in the state. An independent NP would be allowed to practice medicine with oversight only from the Louisiana Board of Nursing.

The NPs will argue that this is about “access” to healthcare and that physicians are threatened by NPs in other ways. So far in the U.S., only 22 states have some form of NP independence. Two states (Maine and Washington) have allowed independent NPs for decades. In these two states, statistics reveal that NPs have been no more willing to go to an underserved area than physicians. If NPs are going to “practice medicine”, they should be required to practice with the same sets of standards and oversight that govern my practice — standards set by the U.S. Medical Licensing Examination, Louisiana State Board of Medical Examiners, and the American Board of Family Physicians.

This debate should occur between the Louisiana State Board of Medical Examiners and the Louisiana State Board of Nursing – not in the Louisiana Legislature! The nursing board is circumventing oversight by asking Grandma when mom said, “No.”
You know grandma’s old saying, “If everyone jumps off the bridge, are you?” Would the lawyers allow the paralegals to practice law without sitting for the bar exam? Would CPA’s allow bookkeepers to perform audits or tax returns without sitting for the CPA exam?

Humbly yours,

Chris Achée, M.D.
Jennings, LA