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The price of a full-page ad in a local county paper costs an average exceeding $500. The Kentucky Medical Association has placed ads regarding “Identify Medical Doctors” in many local papers statewide. The total money spent by this organization on their recent smear campaign targeting non-medically degreed health-care providers probably totals thousands.
This action demonstrates the difference in the discipline of Advanced Practice Nursing and the medically degreed models of care. As Advanced Practice Nurses at a local rural health clinic, we do not turn anyone away if they are uninsured or unable to pay. We never turn anyone away because their Medicaid does not pay us well enough.
We often give patients money from our own income, which is considerably less than that of a medical doctor or doctor of osteopathic medicine, because they cannot pay for medications and sometimes for food. Patients come to us because they have no insurance, no money, sometimes no food and often no hope.
Sometimes patients come to us as referrals from MDs because the patient has lost their insurance and cannot afford the fees charged by their family MDs. If patients call us “doctor,” we correct them and tell them the difference.
We have always shown the MDs of this community respect and have typically worked well with APNs. Therefore we are puzzled by this expensive ad campaign.
We do feel that if the KMA had spent all of this money to help others rather than to malign and discredit the careers of professionals, they hopefully would find something more meaningful in their lives than power, money, possessions and control.
Nurse practitioners serve a vital service in this state; we serve those who cannot afford an MD or DO. We do not give substandard care, although our care is different. We owe no apologies to anyone that some insured, wealthy patients come to us because they prefer our discipline.
We are very well supervised by our governing body, the Kentucky Board of Nursing. The KBN is well known across the country as one of the most strict and conscientious organizations that govern health-care workers.
Anyone may go to the KBN’s Web site and enter a nurse’s license number and see the status of a nurse/nurse practitioner, currency of our license, disciplinary actions, and standing with the board. Publications are sent to licensee’s quarterly, which publish the names of nurses who have been disciplined to create awareness of problems for employers and peers.
The KMA campaign to move non-medical degree health care providers to be supervised by the medical community stems in part from a bill introduced last week to the Kentucky legislature. This bill, if passed, relieves nurse practitioners in private practice of paying an MD $500 to $1,000 per month for a collaborative agreement enabling the NP to write prescriptions for non controlled substance medications (NPs have been doing this since 1996).
This agreement does not hold the collaborating physician legally accountable for any actions by the nurse practitioner and therefore is a useless piece of paper. We believe the collaborative agreement requirement impedes access to health care for medically underserved populations. This bill is in no way meant to represent competition with MDs; it is meant to hopefully recognize the APRN as a competent, respected member of the health-care team in a complementary role.
This bill also requires nurse practitioners who have a DEA number (certification to write for controlled substances) to open a KASPER account (an electronic program in the state of Kentucky used to track prescriptions written for controlled substances). At least three APRNs have been appointed to Gov. Steve Beshear’s task force against indiscriminant use of controlled substances.
In conclusion, I would hope the KMA would reconsider spending so much money on a threat that is no threat at all. Please consider that we have no MD or DO at our clinic. Not one could be found that would take the job we try so hard to do.
Instead of trying to diminish our capabilities in the eyes of our patients become a resource for us. We welcome your assistance.
Jean A. Stodghill, MSN APRN, is a Family Nurse Practitioner, NP-C, and Sharon S. Jamison, MSN APRN, is a Family Nurse Practitioner, BC.