States Continue to Give Nurse Practitioners More Autonomy


In March, Nebraska became the 20th state to adopt a law that allows nurses with advanced degrees to practice without a physician’s supervision. The governor of Maryland recently signed a similar bill, and 8 more states are considering it. Nurse practitioners (nurses who have earned a master’s degree or higher) no longer have to have a signed agreement from a doctor to order and interpret diagnostic tests, prescribe medications, and administer treatments. The laws offering nurse practitioners greater autonomy are being passed in rural states like Nebraska, where medical assistance is limited.

Groups representing physicians, specifically the American Medical Association, are protesting the laws, claiming that nurses do not have the knowledge or the skills to diagnose complex illnesses. Nonetheless, nurses claim that the physicians’ support of mandatory supervision by a doctor stems from competition rather than safety. Moreover, nurses are less costly than doctors to employ and train, which can help provide primary care for Americans that have become newly insured under the Affordable Care Act. According to a 2011 report by the Institute of Medicine, 3 to 14 nurse practitioners can be educated for the same cost as one physician.

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Caroline Smith is currently a senior at the University of Notre Dame and is a contributor to Medical Groups. She is majoring in Science-Business and Spanish. After graduation, Caroline plans on entering the field of healthcare consulting. She is most interested in the evolving policy changes in the healthcare industry and enjoys learning about new technologies that are being developed.