LOS ANGELES (CBSLA) — Assembly Bill 890 would allow nurse practitioners in California to work without physician supervision.
The bill, introduced by Democratic Assemblymember Jim Wood of Santa Rosa, passed out of the California Legislature late last month with a two-thirds, bipartisan vote in the Senate and a 53-1 vote in the Assembly.
Now, it is moving to Gov. Gavin Newsom’s desk, which is the farthest a measure of this kind has gotten in the state so far.
“The nurse practitioners tend to take a little more time with the patient,” NP Theresa Ullrich told CBS2. “This just frees me up to be a little bit more creative in my approach to patients.”
A benefit of the bill that supporters are touting is that nurse practitioners being able to work without physician oversight would help ease shortages in rural and underserved areas, but the flexibility of the bill is making some patients advocates uneasy.
“This bill does not mandate that they go to rural areas. It doesn’t mandate that they go into primary care,” said Dr. Laura Kendall, a psychiatrist and member of Physicians for Patient Protection.
“When you don’t know what you don’t know, really bad things can happen. It requires many years of training to know all of the possibilities,” she said. “When there’s no supervision required, they can just then replace physicians with nurse practitioners and so people who are stuck in that system have no choice… and those who can afford it can go outside that system.”
Twenty-two states and Washington, D.C. already allow nurse practitioners to work independently, and legislation similar to AB 890 is also being considered in Texas.
The California Medical Association, which represents nearly 50,000 physicians in California, argues that the bill as it stands does not prioritize patient care.
“Corporate hospitals are backing this bill as an end-run against key patient protection measures that prohibit them from directly employing physicians. This has much more to do with corporate profit than it does access to care,” the organization said.
After medical school, family physicians must complete three years of residency and more than 20,000 clinical hours.
Master’s programs for nurses can take up to three years and requires between 500 and 1,500 clinical hours to graduate. Advanced training and education can also be pursued.
If Gov. Newsom signs AB 890, it will not be implemented until 2023.