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Did you know that legislatures across the United States (and especially in TN) have an opinion, and are making laws that affect the care you receive from your health care provider? It is scary to think that non-health care constituents are, in fact, dictating how we as providers can care for you. Let me give you a prime example:

Senator Randy McNally from Oak Ridge, TN was a hospital pharmacist before he made a successful run for senate.  Nonetheless, he is planning to introduce Senate Bill 0976 in the upcoming legislative session. This bill will be detrimental to the care you currently receive – whether you see a Nurse Practitioner, a Physician’s Assistant or a Physician. Let me explain why.

If Senator McNally’s Bill 0976 is successful, it would limit Nurse Practitioners from prescribing ANY scheduled drugs – this would include: opioids, ant-anxiety medications, as well as ADHD/ADD medications – just to name a few. So, why would this matter to you – well if you are prescribed these medications then your Nurse Practitioner would no longer be able to prescribe these medications.  You would be forced to see a specialist and the wait to see a provider that can actually write these medications will be very long, if it even exists.  So, your access to care (regardless of your insurance) will be greatly limited.  Also, this will greatly reduce many patients access to the care they currently receive. Many rural communities may only have a Nurse Practitioner caring for these people. If they can no longer prescribe these medications – they will begin flooding emergency rooms, because they simply cannot get transportation to a physician that can prescribe these medications. So, that in and of itself, leads to increased health care costs, which we in the state of TN or the nation DO NOT HAVE!

So, my first question is: Are there studies or outcomes to show that Nurse Practitioners prescribe these medications inappropriately or in an unsafe manner? THERE IS NOT!! There are no studies to show poor outcomes as a result of Nurse Practitioners prescribing these medications. Studies do in fact; show that Nurse Practitioners and Physician’s Assistants are less likely to prescribe these medications than physicians, therefore making them more cognizant of the problems that exist with these medications.

It is also important to know – that currently in the state of TN, Nurse Practitioners are under supervision of a collaborating physician while prescribing these medications. That means that every patient that sees a Nurse Practitioner where a controlled substance is prescribed – those charts MUST be signed by a physician. So, explain to me the relevance of taking away a Nurse Practitioner’s ability to prescribe these medications? As it stands now, if a Nurse Practitioner is prescribing an inappropriate amount of a scheduled medication, then a physician is signing this chart and agreeing with their dosing and prescribing. So, ultimately, the physician is at fault for these prescribing habits. 

Did you know that, currently 18 states and the District of Columbia allow Nurse Practitioners to diagnose and treat patients and prescribe medications without a physician’s involvement?  It looks as if Tennessee is in fact moving backwards, as Obamacare is moving forward.  How will we care for the 32 million people that will have health insurance next year, if we are not able to adequately prescribe appropriate medications?

Another important fact to consider is that the prescription abuse problem became very prevalent in FL, as FL cracked down on this behavior it began moving north – into AL, GA and into TN. Florida and Alabama have two of the most confining prescribing laws for Nurse Practitioners. Therefore, it is evident that with stricter control of Nurse Practitioner, comes NO better outcomes on the prescription drug abuse problem.

Is there a prescription drug abuse problem: ABSOLUTELY!! Are Nurse Practitioners the problem? Yes, a few – under supervision of a physician. Are Physicians the problem? Yes, some. So, it only makes sense to me that the state of TN needs to go to the offending prescribers, whoever they are. There needs to be required continuing education for all prescribers of scheduled medications. There also needs to potentially be caps on the amount of controlled substances that can be prescribed, before a patient must be sent to a specialist for further dosing increases – thus leading multidisciplinary approach to care.

BUT, there is absolutely NO reason why Nurse Practitioners should not be able to prescribe an appropriate amount of scheduled medications, or any data that shows that this regulation would help the current problem we have in the states of Tennessee.

So, here are what we as health care providers need from you: Please take a moment to voice your concern via email or a phone call to your senator. They need to be hearing from their constituents. If you don’t know who your senator is, click on this link: http://www.capitol.tn.gov/legislators/

You deserve the very best possible health care. So, please let your senator know to vote “NO” on Senate Bill 0976.

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