Adele Caruso asserted in The Tribune-Democrat that nurse practitioners should practice without physician collaboration because they have increased in numbers throughout Pennsylvania. The Pennsylvania Medical Society does not believe it justifies removing the important patient safeguard that a collaborative agreement ensures.

NPs have been trying for years to remove collaborative agreements in Pennsylvania. Prior this editorial, the NP lobby led us to believe that NPs were leaving Pennsylvania for states that permitted independent practice and that they could not attract more without discarding collaborative agreements.

This data, which show an increase in NPs coming to Pennsylvania, undermines that argument.

While NPs deliver excellent care within the physician-led team concept, their skills are not interchangeable with physicians.

Becoming an NP is shorter and less arduous (500-750 hours of education/training) compared to becoming a physician (12,000-16,000 hours).

NPs can already diagnose, establish treatment plans, order diagnostic imaging studies and other tests and prescribe almost all of the same medications that physicians prescribe. A collaborative agreement isn’t an impediment; it ensures deeper medical expertise is immediately available, especially for complex cases.

While medical schools have a rigorous standardized curriculum, some NP programs are 100% online. As someone who has completed medical school and residency, I can attest that it is difficult to replace this “hands-on” training through online learning.

Pennsylvanians deserve equal access to the highest quality care, which I believe involves physicians and NPs working together.

Dr. Lawrence John

President of Pennsylvania Medical Society

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