The House Health and Human Services Committee room was packed with advanced nurse practitioners who came out to support a bill to allow them prescribe Schedule II and III prescription drugs including Lortabs, Percoset and Morphine without consultation from a physician. The need for the doctor's note to prescribe the pain pills they argued was a burden to their practices, but for committee members the inconvenience and didn't outweigh the risks for a state repeatedly ranked as one of the top ten worst states for prescription drug overdose fatalities.---
Rep. Paul Ray, R-Clearfield presented his House Bill 139 to allow advanced nurse practitioners to not be mandated to take part in consultation referral agreement, that require them to enter into agreements in order to be able to prescribe powerful pain medications. The agreements he pointed out can in some cases come with high fees charged advanced nurse practitioners, even though the practitioner and the doctor may not even work in the same hospital or even city, county or region of the state. Ray saw it as an impediment to advanced nurse practitioners being able to operate, affecting healthcare especially in rural clinics run by advanced nurse practitioners where they may be the closest medical care for miles.
Ray also argued that since doctors and advanced nurse practitioners have to follow many of the same licensure training and ongoing education requirements they ought to be on the same footing when it comes to prescribing authority.
Jared Johnson, President of the Utah Nurse Practitioners Association says his profession is dedicated to patient care and doesn't need a mandated program, especially when it doesn't work the way its supposed to.
“The consultation referral program as it is now hasn't provided any direct oversight,” Johnson said. “I work in a group with two physicians. They work in a different hospital, they work in Orem, I work in Payson,” Johnson said, that adding that if the required consultation is done away with “they will always be available. I will always consult with other physicians when added expertise is required.”
The diagnosis from doctors on the committee differed, however, with Rep. Edward Redd, R-Logan, a physician, arguing that “having someone look over your shoulder has benefits.” Redd said that in his experience most nurse practitioners work closer in “team models” in the same facilities as physicians.
He also added candidly that more collaboration can make a life or death difference. “In 25 years of practice I know I've been on the prescribing end of some people's deaths,” Redd said. “To say 'we don't need any oversight' is a problem for me.”
Rep. Michael Kennedy, R-Alpine, who is also a physician, challenged the mandated program as an over-rated cure all.
“The fundamental question is whether this piece of paper makes any difference?” Kennedy said. “I think any one of us wants to take good care of the patients that are trusted to us in whatever setting we're in.”
Still the grim specter of Utah's prescription drug overdose problem hung over the minds of committee members Rep. Tim Cosgrove, D-Murray, cited his experience on the state suicide prevention board to note 502 deaths in the state last year tied to prescription drug overdoses. For Cosgrove, irrespective of any turf war between nurse practitioners or doctors, it was the proliferation of pills that worried him.
It bothered enough committee members that HB 139 was ultimately defeated by a 5-to-3 vote.
To read HB 139 click here. To contact Rep. Ray about this issue click here. To find your legislator to contact them about this issue click here. For more updates from the hill visit CityWeekly.net and follow @EricSPeterson and @ColbyFrazierLP on Twitter.