For those of you who may not know, I work as a nurse practitioner in Kentucky. Since I began working about 7 years ago, there has been a small piece of paper (a Collaborative Agreement) which has to be signed by a physician to give me the authority to prescribe medications. I have actually chosen NOT to have a DEA number so I have never written for controlled meds. Therefore, most of my prescriptions consist of antibiotics, anti-depressants, hypertensive or diabetic management drugs. In my situation, the Collaborative Agreement has never been a huge obstacle to practice as a physician I work for always signs the paper without any conflict or cost. An example of a Collaborative Agreement can be viewed here .
Nurse practitioners have always worked independently from physicians since I have been employed, meaning there is no requirement to consult with a physician prior to prescribing (for example): Penicillin for strep throat. Nurse practitioners are educated to treat minor acute illnesses or injuries such as sorethroat, sinusitis, urinary tract infection, sprained ankle, etc. They are also trained to treat controlled chronic illnesses such as hyperlipidemia, hypertension, or diabetes. Patients, in my practice, are always encouraged to see a physician for poorly controlled chronic illnesses or serious acute illness or injury.
The biggest problem I see with the Collaborative Agreement requirement is when a nurse practitioner chooses to open his or her own business. Often (not in all situations) there is a substantial cost to enter into the Collaborative Agreement with the physician. If the physician, at any point in time, decides to end the Collaborative Agreement, then the nurse practitioner can no longer practice in his or her own business.
HB 282 : Amend KRS 314.042 to delete the requirement for an advanced practice registered nurse to enter into a collaborative agreement with a physician before engaging in the prescribing or dispensing of nonscheduled legend drugs. From http://e-lobbyist.com/.
The bill (HB282) was passed by the House of Representatives with a final vote of 80 to 16 and has now been received by the Senate. I encourage all readers from Kentucky to call your Senator and ask him or her to vote YES for HB 282. You can a view a list of talking points here before contacting your Senator. If you are unsure how to contact your Senator, then please click here .