 Nurse practitioners would like the state to take the shackles off what they are allowed to do on their own, a joint legislative study committee was told Tuesday. But some aren't sure the state should change those restrictions, as South Carolina did last year for nurse practitioners and last month for physician assistants. Show The House & Senate Study Committee looking at physician supervision of mid-level practitioners, such as nurse practitioners and physician assistants, met for a session at Children's Hospital of Georgia to hear from health professions schools at Augusta University on their programs. College of Nursing officials made a strong plea for Georgia to join most other states in allowing greater flexibility for advanced practice nurse practitioners to be allowed to do more. For instance, in Georgia they cannot prescribe Schedule II drugs, which are defined as drugs that are dangerous with a high risk of abuse and include the opioids OxyContin and fentanyl. Georgia is one of only five states that don't allow them and physician assistants to do that, said Sen. Chuck Hufstetler, R-Rome, who co-chairs the study committee with Rep. Mark Newton, R-Augusta. Georgia is also the only state that does not allow nurse practitioners to order advanced imaging, such as CTs and MRIs, said J. Dwayne Hooks Jr., executive associate dean for the College of Nursing. "We have a very restricted state practice environment," said Dr. Lucy Marion, dean of the college. In fact, "we are the most restricted state in the United States," she said. While there are more than 15,000 nurse practitioners licensed in the state, probably only 9,000-10,000 actually practice in Georgia and it is difficult to recruit them here, Marion said. "They don't move here because they know they can't practice fully here," she said. Nurse practitioners in Georgia have to have a practice agreement with a physician on file at the Composite State Board of Medical Examiners, Hooks said, and that board, which oversees physicians and their licensure, wrote the rules for their practice. But there is no evidence that requiring physician supervision improves the quality of care, Marion said. "What is the value to the health system" to supervise nurse practitioners, she asked. "I don't see it." South Carolina last year allowed nurse practitioners to write Schedule II drugs with certain restrictions and last month extended that to physician assistants. Both can also refer patients to physical therapy, determine disability and can declare a patient dead and sign a death certificate, among other recently removed restrictions. Georgia law expressly forbids that prescriptive authority but even some physicians are coming around about it. Hufstetler, who is a physician assistant anesthetist, said some of the cardiothoracic surgeons he works with have asked that their physician assistants have that authority so they can discharge the patients with pain relief post-surgery instead of the surgeon having to do it at the end of a long day in the operating room. But some point to the much longer training physicians receive compared to the mid-level providers. Nurse practitioners in Georgia must complete a doctoral program on top of a baccalaureate, with more 1,500 clinical hours, and physician assistants complete a 27-month program with three semesters of supervised clinical training. Medical students, however, have many thousands of hours more clinical time before they graduate and must complete at minimum a three-year residency before being allowed to practice, witnesses told the committee. "When I finished medical school, I wasn't halfway through my training," said Sen. Kay Kirkpatrick, R-Marietta, who is a hand surgeon who did a six-year residency in orthopedic surgery. The country is also in the midst of an opioid crisis although Georgia has started to see a drop in its prescription opioid deaths and "we're proud of that," Newton said. State officials have been very cautious about doing anything that could be perceived as adding to the supply of those drugs, he said. But as an emergency room physician and medical director/CEO of the MedNow Urgent Care clinics, Newton said he works alongside those mid-level practitioners and knows the value of their contributions. The committee "is looking at things that can make practice in Georgia more attractive for people who want to move here," he said, but wants to be careful about lifting any restrictions. "We're looking at how to thread the needle," Newton said.
Next meetingHow many NPs can a physician supervise in Georgia?PAs in Georgia are licensed by the Georgia Composite Medical Board (“GCMB”). ratios, a physician may enter into agreements with no more than eight APRNs and supervise no more than four at any one time. There are five types of APRNs recognized: 1.
Do Georgia nurse practitioners need a supervising physician?Georgia's Nurse Practitioner Supervision Laws
Nurse practitioners practicing in Georgia must work under physician supervision. NPs and their physician supervisors must work together under a “nurse protocol”.
How many app can a physician supervise in Georgia?A physician may not be an employee of the physician assistant who he/she is required to supervise unless the arrangement was approved by the Board prior to July 1, 2009. A physician may serve as primary supervising physician to only four physician assistants.
How many NP and PA can a physician supervise?The law limits a physician to supervise no more than four Physician Assistants.
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How many nurse practitioners can a physician supervise in georgia
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