Supervising Nurse Practitioners
"Nurse practitioners are one of the fastest-growing fields of primary care medicine in Texas, where more than 16,000 are currently practicing, and around the country, where the number of nurse practitioners has doubled to more than 200,000 in the past decade alone. As they have become more prevalent, nurse practitioners have started pushing to become increasingly independent practitioners of medicine. So far they are autonomous in the District of Columbia and 22 states — but not Texas. But there has been a pronounced effort to give nurse practitioners the right to practice to the “full extent of their license and education” in recent years.
This has been met with frustration and anger by medical doctors, who insist nurse practitioners are good at what they do but should not be allowed to work independently since they have less medical training and their education is handled in an entirely different way. (
It’s such a controversial subject that most of the doctors the Houston Press spoke to for this story agreed to do so on condition of anonymity, because they say they could lose their jobs.)
...
Memorial Hermann has replaced primary care physicians with nurse practitioners in its clinics, according to Houston doctor Latisha Rowe (she was replaced by a nurse practitioner when she left one of the Memorial Hermann clinics, she says), and Houston Methodist already has a special emergency team that is led by nurse practitioners, according to its website. The U.S. Department of Labor Statistics predicts that nurse practitioners will be used even more in coming years since they are cheaper to hire and help both hospitals and medical offices cut costs while increasing the number of medical providers.
Dr. Kara Baker (not her real name) is a hospitalist, a doctor who sees patients only in hospitals, in the Memorial Hermann Health System.
Baker says that Memorial Hermann has been quietly considering moving to a system in which each physician will oversee two or three nurse practitioners at a time both in hospital emergency rooms and within the hospital system itself.
If that happens, Baker says, she will have no choice but to take on nurse practitioners — and the liability that comes with any mistakes they may make — because it is in the contract Memorial Hermann has doctors sign. But it will be difficult, she says, because so much of what nurse practitioners do is vaguely defined."
I understand why the individual docs are afraid to release their real names. The fear of retribution is huge. Fear that their hospital employer will fire them. Fear that the nursing clan will find ways to make their life miserable at work. Tons of nasty reviews on online review sites. Extra pages at work. Getting written up for any perceived slight.
