Nurse practitioners ease doctor shortage, but will have to wait to get more authority to prescribe narcotics; opioid epidemic cited

practitioner Robin Szczapinski talks with her patient, 
Harold Brashear
Sr., at the Louisville Veterans Affairs Medical
Center. (Courier-Journal photo by Maggie Huber)

They’re not doctors, but they do a lot of the same things, probably most things most patients need. They’re nurse practitioners, officially known as advanced practice registered nurses, or APRNs. Kentucky has 5,400 of them, and they are helping ease the state’s shortage of doctors, reports Darla Carter of The Courier-Journal.

“Since the expansion of the Affordable Care Act, there’s been an
increased need for primary care providers and there’s just not enough
physicians within the state of Kentucky,” Lewis Perkins, a
geriatric nurse practitioner and chief nursing officer at Louisville’s Norton Hospital, told Carter.

Nurse practitioners in Kentucky must have a collaborative agreement with a physician to
prescribe narcotics and some other controlled substances, and for the first four years of prescribing, other drugs. They would like those restrictions removed, and a bill in the legislature would do that.

The sponsor of Senate Bill 158, Sen. Paul Hornback, R-Shelbyville, told Carter he introduced the bill only to get discussion started. It did, at least for people whom Carter contacted.

Dr. William C. Thornbury, president of the Kentucky Academy of Family Physicians,
sent Carter a statement saying the bill “conflicts with our
governor’s policy to combat opioid abuse. Removing the collaborative
agreement between a physician and an APRN eliminates the consultation
process, which is an important protection in place that helps curb the
abuse that is ravaging our commonwealth.” The Kentucky Medical Association also
opposes the bill, citing similar reasons.

Wendy Fletcher, a “doctorally-trained nurse practitioner” and president of the Kentucky Coalition of Nurse Practitioners & Nurse Midwives, “noted that nurse practitioners are monitored through the U.S.
Drug Enforcement Administration and the Kentucky All Schedule
Prescription Electronic Reporting (KASPER) system – just as physicians
are – and are held to a high standard by the Kentucky Board of Nursing,” Carter reports.

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