June 2, 2023

ACEP Speaks Out Against Bill to Expand Nonphysician Scope of Practice

ACEP strongly opposes the “Improving Care and Access to Nurses (I CAN) Act (H.R. 2713).

Standing with nearly 100 physician organizations, ACEP signed onto a June 1 letter to Congress outlining significant concerns that this bill would allow nurse practitioners, physician assistants, and others who are not physicians to perform duties outside their education and training.  

In an emergency, patients expect and deserve the most qualified available member of the care team, an emergency physician, to lead their medical care.

Multiple studies reinforce concerns that permitting nurse practitioners, physician assistants, or others who have not obtained the training or education of a physician to practice independently can result in lower quality and higher cost care.

Nonphysician practitioners “tend to prescribe more opioids than physicians, order more diagnostic imaging than physicians, and overprescribe antibiotics—all of which increase health care costs and threaten patient safety,” the letter cites.

Additional evidence is detailed in a working paper published by the National Bureau of Economic Research. This study concluded that nurse practitioners delivering emergency care without physician supervision or collaboration increase lengths of stay by 11% and raise 30-day preventable hospitalizations by 20% compared with emergency physicians.

ACEP firmly believes an emergency physician should be in charge of the care delivered at every emergency department in the country. We will continue to speak out in support of emergency physician-led teams.

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