LOUISIANA STATE MEDICAL SOCIETY
AM 2024 DESTIN
HOUSE OF DELEGATES
RESOLUTION 204
Defining Supervision of Physician Assistants and Nurse Practitioners
SUBJECT:
Medical Student Section
INTRODUCED BY:
WHEREAS, current Louisiana State Medical Society policy holds that “non -physicians should only deliver care under the supervision and leadership of licensed physicians,” and that health system teams or team health approaches to patient care should involve a licensed physician as director of the team who should “be immediately available for onsite consultation and held accountable for all actions thereof”; and WHEREAS, current Louisiana state law holds that supervision of physician assistants “shall be continuous but shall not be construed as necessarily requiring the physical presence of the supervising physician at the time and place that the services are rendered”; and
WHEREAS , the supervision of physician assistants and nurse practitioners is often merely nominal; and
WHEREAS , many nurse practitioner programs require a minimum of 1 to 2 years of clinical experience prior to entry; for a full-time nurse, this translates into 2,000 to 4,000 hours of nursing experience. Clinical training in a nurse practitioner program is typically 500 hours. Physician assistant programs typically require an average of 3,500 hours of experience before entry, with clinical training spanning 2,000 hours. Clinical hours for medical students are around 5,000 hours (assuming a 60-hour work week), with a 3 to 4 year residency programs requiring 13,500 to 18,000 hours 1 ; and WHEREAS , while the expansion of nurse practitioner and physician assistant was originally intended to address the needs of primary care, their growth has now expanded into other specialties; in its current state, the variability in on‐boarding training, clinical hours, and postgraduate training education makes it difficult to support autonomy of non physician providers 1 ; and WHEREAS , nurse practitioners increased lengths of stay by 11%, increased cost of emergency department care by 7%, and increased hospitalizations by 20%. Thus, they increase cost and achieve less favorable patient outcomes 2 now, therefore, be it RESOLVED, that the Louisiana State Medical Society (LSMS) submit a resolution to the American Medical Association (AMA) and American Osteopathic Association (AOA) for increased research initiatives aimed at evaluating patient safety outcomes, scope of practice implications, and cost- effectiveness pertaining to nurse practitioners and physician assistants; and, be it further
RESOLVED, that the LSMS seek and/or support legislation to strengthen the supervisory requirements for mid-level providers.
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