re: SB 435 would allow advanced practice nurses to not work under a physician

You are referring to a pharmacy query.

A physician can do a query on his or her patient, and get a report showing what scripts they are getting, from what doctors, and at what pharmacies. This has helped to prevent people from getting pain meds from multiple doctors.

Caution: a physician cannot do a query on someone not his patient. That's a big no-no.

as a risk management consultant/insurance broker for hospitals and physician groups.....this would be expensive on many levels. And also just a bad idea.

Plaintiff attorneys finna eat.

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I think antibiotic stewardship is a huge issue, and one that will only worsen as less trained providers have more autonomy.

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I'll be the first to admit it: physicians tend to suck at this too. Particularly in an urgent care or ER setting. It's purely speculative as to whether less trained providers help or hurt it, but I've got my money on "not help."


I've also recently adopted the idea of post-dating the script when the patient is unsure or follow up is going to be difficult. First one I did this for (moonlighting in an urgent care when a young, healthy person had a 2-day sinus infection), I actually ran into them a few days later. They thanked me and told me they never filled it but felt better just as I had predicted.

No, I'm not delusional and think that's always going to be the case. But I got pretty excited in that instance. We (everyone that writes scripts) need to do a better job at antibiotic stewardship. My current biggest fear is that the current push and agenda is "no opiates" and that it's going to spiral out of control without being in the spotlight.

If people are stupid enough to trust their health to just an NP then I say let them go right ahead.

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The quality of Midlevels greatly. Some are really good and really really bad.

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Same is true of MDs

I've worked with mid-level providers my whole career. I really don't see a problem with NPs and PAs providing unsupervised basic medical services that are kind of "by the book" anyway. My bigger issue is the inevitable "mission creep" that will almost surely happen. Once these providers get this right...the push for increase of scope will continue. Next..out of hospital and private clinic privileges. After that, the right to perform medical procedures. Finally, the right to give themselves the title "Doctor" and advertise as such. Consumers of health care should know what they are getting and what the provider's qualifications are. This action blurs this line.

The author of the bill is the Chairman of that committee. That bill was coming out no matter what.

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That has been done, and there is no evidence of improved outcomes.

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That's true, but "quality" isn't really the goal. Access is, and costs to a lesser degree.

I'd like to see the loss forecasting for this to be a financial winner. There are a handful of highly litigious states that are already attempting to cap their malpractice losses through a patient compensation fund, and NP's can enter. LA included.

Everything makes sense on paper out the gate. Give it a few years when these huge verdicts come out. No one seems to account for the creative plaintiff attorney.