re: Defeat the Nurse Practitioner scope of practice expansion - Louisiana SB 187

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I guess she was trying to convey that she felt comfortable enough with her patient population and practice area that she didn't need daily or frequent contact with the collaborating physician.

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She was trying to say "look, I don't have any tangible physician oversight so why would any NP need any oversight" and she is stating it in a way that makes it seem as if she was practicing completely independently. In our current tech driven world, telemedicine is a very real thing. The doc may have been doing an excellent job of reviewing 20% of her charts, giving frequent constructive feedback, having daily Skype discussions with her, and taking multiple calls per day with photo evidence and detailed questions when she had concerns. And he could have done all of that without every physically stepping in the clinic. I fully realize this is very likely not the case. However, pointing out her limited physician involvement either by her choice or his does not equate to no physician oversight.


When a system is in place and someone fails to adhere to the system, the system either needs to be strengthened or that individual needs to be educated and reprimanded. You do not scrap the entire system in favor or everyone doing things the wrong way just like the example.


It is about as logical an argument as saying "despite the law, and having seatbelts in my truck, I have only worn a seatbelt twice in 8 years, we need to remove the seatbelt law because of this."

Yep the law is to protect the public. Removing it bc it proves to be inconvenient to the clinicians is not a good option.

Hypothetical question:
Do you think the worst, most poorly trained physician is a better practitioner than the best and most educated NP?

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most poorly trained physician (assuming state medical board approved to practice)

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most educated (assuming exclusively required NP school education) NP

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However, there are total shite bags in every profession so,

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the worst physician

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the best NP

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especially since the best NP by definition will understand their scope of practice and limitations and defer to a trained physician when needed.

It would make it unlimited

That is not a pertinent question and is irrelevant to the bill

are you allowed to write triplicate prescriptions (schedule II )now in LA? or do you have to have a physician sign off on them like here in TX?

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All it would change is not requiring a collaborative practice agreement

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And why would NP's not want to collaborate?

no change in scope means no change in services offered
no change in scope means no change in reimbursement
no oversight means higher liability

Who would limit your scope

I hope I get the chance to work with you one day