In testimony before the Ohio House Medicaid Committee, Dr. Christina Campana stood strongly in opposition to House Bill 508, legislation that would remove legal requirements for physician collaboration with advanced practice nurses.
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"Emergency medicine works best as a team sport, and physician-led care is central to that success." —Dr. Christina Campana, president, Ohio ACEP |
Dr. Campana called attention to multiple large studies, including a Stanford University analysis that shows independent practice by unsupervised nurse practitioners leads to high rates of unnecessary testing, imaging, and increase in ED referrals —increased costs without measurable improvement in quality of care. She said:
“It’s not about hierarchy, it’s about safety, teamwork, and accountability for the patients we serve.
We should maintain standards and collaboration that keep patients safe and ensure consistent, high-quality care across Ohio. Removing physician involvement does not expand access, improve outcomes, or lower costs—the data, workforce trends, and the stories from our front lines make that clear. As emergency physicians, we work side by side every day with APPs and deeply respect their contributions.
Just as no pilot flies without co-pilots and a checklist, medicine works best when we work together—with clear roles, shared responsibility, and accountability to our patients. For these reasons, I urge you to oppose HB 508.”
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