Kingston, New York medical malpractice lawyer reveals why the nurse practitoner law in New York is much to do about nothing

A new law in New York will free nurse practitioners from doctors. The legislation, known as The Nurse Practitioner Modernization Act, eliminates the physician supervision and the collaborative agreement requirements for nurse practitioners.

A nurse practitioner is a registered nurse who has a master's degree. Nurse practitioners practice medicine in different medical specialties, such as primary care, geriatrics and pediatrics, and they can even operate their own medical office without a physician.  Talk about practicing medicine without a medical degree--no wonder physicians are upset! 

There are two small "buts"--nurse practitioners are required to have a written practice protocol and a practice agreement with their "collaborating physician".  A written practice protocol is a written agreement prepared by the "collaborating physician" that spells out the scope of the nurse practitioner's authority, i.e., what she can do, such as prescribing narcotic medications, admitting patients to a hospital, performing spinal taps, etc.  The practice agreement is a written agreement prepared by the collaborating physician that governs the relationship between the nurse practitioner and the collaborating physician, i.e., chart reviews of patients, what to do if there is a disagreement about a plan of treatment, etc.

Roughly half of nurse practitioners ignore the legal requirement that requires that they have a written practice protocol and a written practice agreement!  If you ask a nurse practitioner about her written practice protocol, she may look at you with a blank expression on her face (maybe half kidding) as if to say, "what's that?" (I'm no longer surprised by that response).

Here's the reason the new law is totally and completely meaningless: nurse practitioners already practice medicine independent of their "collaborating physician".That's right--there is no supervision of nurse practitioners by physicians except perhaps in the very rare medical practice.  Despite what they say, nurse practitioners consider themselves the equal of physicians and they resent it when you ask to see a physician.

Even worse, doctors rarely review the medical charts of patients' who are seen by nurse practitioners.  Even though the law in New York requires a physician to review the nurse practitioners' medical charts at least once every three months, that almost never happens.  Nurse practitioners and their collaborating physicians are often unaware that the law requires chart reviews by a physician at least once every three months. It is stunning how little nurse practitioners and their collaborating physicians know about New York law.

By the way, why does it even make a difference if a physician reviews a nurse practitioner's charts once every three months?  By the time the physician reviews the medical chart every 90 days, patients might be dead.  True oversight requires daily monitoring of treatment provided by nurse practitioners and this is accomplished by physician reviews of the medical charts at the end of each work day.

The most common mistake I see in primary care practices is a nurse practitioner taking care of a patient with a complex medical condition.  Forget about physician supervision--a nurse practitioner should NEVER treat patients with complicated medical conditions.  Hell, a primary care physician should rarely treat complex medical conditions!  If you have a complicated heart abnormality, you should be treated by a cardiologist, a specialist in treating heart conditions.

So what can a good patient do?  If you have a simple, routine medical condition, there's no need to worry--a nurse practitioner will do just fine.  If you have a medical condition that is more complex, such as diabetes or heart failure, you must insist that you are treated by a physcian--in other words, someone with an actual medical degree.

If you have any questions or want more information, I welcome your phone call on my toll-free cell at 866-889-6882 or you can always request my FREE book, The Seven Deadly Mistakes of Malpractice Victims, at the home page of my website, www.protectingpatientrights.com.  Thank you for reading my blog!  I welcome any comments or observations to this blog.


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