Scope of Practice Update: Optometrist and APRN Bills Discussed; NC Ob-Gyns Adopt New Policy

It has been a busy few weeks on scope of practice issues. In brief, here is the latest:

HB36 – Enact Enhanced Access to Eye Care Act

The North Carolina Society of Eye Physicians and Surgeons (NCSEPS) held a press conference yesterday, Tuesday, March 21, to release the results of a survey they conducted to assess how voters feel about HB36, which would authorize optometrists to perform eye surgery with lasers and scalpels. The statewide poll revealed that nine out of 10 North Carolina voters oppose HB36. Read the press release and survey results.

One interesting bit of data revealed that when told that the North Carolina Medical Society (NCMS) opposes HB 36, public opposition to the legislation rose to 89 percent overall, and 91 percent among Republicans illustrating once again the influence of the NCMS not only among legislators at the General Assembly, but also with the voting public.

HB88/S73 – Modernize Nursing Practice Act

Last week, on Wednesday, March 15, the Chair of the NCMS Legislative Cabinet, William G. Ferrell, MD, a neurologist with Raleigh Neurology Associates, family physician, Conrad Flick, MD, and Director of the NC Society of Anesthesiologists R. Paul Rieker, Jr., MD, testified before the House Health Committee in opposition to HB88. Watch the hearing to see these physicians testify as well as hear the nurses’ representatives. The entire hearing runs about an hour, but we’ve broken it into two installments.

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The bill seeks to eliminate physician supervision for nurse practitioners, certified nurse midwives, clinical nurse specialists and certified registered nurse anesthetists. This effort is nothing new, but putting these various practitioners into one bill has not been done previously.

The NCMS opposes this bill because it undermines the team approach to care delivery. Under current statute, advanced practice RNs are allowed to practice to the top of their individual training and abilities. By eliminating physician supervision and reducing their scope of practice to specifically what is outlined in a statute, NC nurses will be left with a shared definition that is the lowest common denominator skillset. Learn more about this bill.

NC Ob-Gyn Society Changes Its Stance on Supervision

The North Carolina Obstetrics and Gynecology Society (NCOGS) recently announced a change in its policy on physician supervision of certified nurse midwives. The new stance calls for a licensure process that acknowledges certified nurse midwives as independent health care professionals and requires a physician collaboration agreement. Currently, the state requires certified nurse midwives to be supervised by a physician.

This new arrangement brings the organization closer to the American College of Obstetricians and Gynecologists policy, which supports complete independent licensure. The new NCOGS policy more closely aligns with the current collaboration between North Carolina physicians and their nurse midwife colleagues.

“The Ob/Gyn Society’s decision to change its position on this issue came after more than a year of review by a diverse committee of Ob/Gyns from across North Carolina,” wrote NCOGS President Cecilia F. Grasinger, MD. “The committee reviewed current law, other states’ rules, as well as the policies of the American College of Obstetricians and Gynecologists. After the committee recommended a change in our policy, the NC Ob/Gyn Society’s Executive Committee unanimously accepted the committee’s recommendation.”

Read Dr. Grasinger’s letter. You can also view a short video on the change.

The policy change will not have an immediate impact on licensure, but will influence policy discussions at the General Assembly.

The NCMS remains opposed to HB88, which includes allowing certified nurse midwives and other advanced practice nurses to practice without physician supervision as described above.

 
 

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