Many hospitals are responding to resource constraints and staffing challenges by allowing nonphysicians—like physician assistants or nurse practitioners—to perform complex medical procedures without supervision.
ACEP believes that an emergency physician should lead every emergency care team in the country. Physician assistants (PAs) and nurse practitioners (NPs) are integral and valued members of the care team. But they do not have the training or expertise of an emergency physician. Regardless of where a patient lives, anyone who goes to the emergency department deserves access to the highest quality care delivered by emergency physician-led teams.
ACEP is making it clear: there is no substitute for a licensed, trained, and board-certified emergency physician. ACEP has launched a campaign to educate patients and policymakers about the importance of physician-led care teams.
ACEP advocates at the state and federal levels for policies that prioritize emergency physician-led teams in the emergency department. We are working to establish commonsense principles for model state legislation and best practices for scope of practice in the emergency department as we fight back against bills that would expand the scope of nonphysicians.
There have been more than 70 bills introduced in state legislatures seeking to expand scope of practice for nonphysician health care professionals across medical specialties and functions, according to the National Conference of State Legislatures.
During the 2021-22 legislative session, emergency physicians worked to defeat HB 354, a bill that would have removed the physician-collaboration requirement for APRNs for prescribing in Kentucky.
ACEP was part of the coalition that successfully advocated for the governor of Wisconsin to veto SB 394. This bill would have removed physician supervision or collaboration requirements for nurse practitioners, nurse anesthetists and clinical nurse specialists after 3,840 clinical care hours in their APRN role with a physician or dentist.
Emergency physicians in Colorado were instrumental to defeating HB 1184, a bill that would have removed the supervision requirements for physician assistants and required formal collaboration with a physician only for PAs with fewer than 5,760 hours of experience.
In South Dakota, emergency physician advocacy prevented SB 134 from passing in the Senate.
And, a strong effort in Louisiana was essential to defeating a bill that would have granted full practice authority to advanced practice registered nurses.