Task force can’t resolve doctors-versus-nurses turf war

A divisive “turf war” between doctors and nurse practitioners has broken out across Tennessee and a state task force created by state legislators to find common ground has, thus far, only illuminated the depth of the schism, reports The Tennessean.

The dispute centers on exactly what types of treatment can be provided by advanced practice registered nurses (APRN), and under what level of oversight. Tennessee is among the dozen states with the most restrictive scope of practice laws — and the reform debate is a recurring flashpoint in legislative sessions. The nurses contend they are equipped to administer many of the same primary care and preventative treatments as doctors. Further, they point to a growing primary care physician shortage across the region.

Doctors, meanwhile, question whether nurse practitioners can offer the same level of care and have opposed efforts to expand the scope of treatment, preferring legislation to reinforce physician roles in primary care.

The task force created by Sen. Becky Massey, R-Knoxville, and Rep. Jeremy Faison, R-Cosby, was designed to give doctors and APRNs — nurse anesthetists, nurse practitioners, nurse midwives and clinical nurse specialists — a forum outside of legislative session to find consensus on how to reform the rules governing treatment. The resulting recommendations could result in legislation that impacts how Tennesseans receive primary care — a key step toward improving the state’s dismal health.

Yet the debate has devolved into a fight between doctors and nurse practitioners, with both sides becoming entrenched and the task force’s meetings becoming forums for people to air individual frustrations and opinions.

“Reluctantly I say no (we haven’t made progress). We’ve met twice and we’re closer to the beginning than the end,” said Dr. John Hale, a primary care doctor in Union City, who is co-chair of the panel alongside Carole Myers, a registered nurse and associate professor at the University of Tennessee College of Nursing.