Before I start this article, I feel it necessary to let everyone know that my wife is a nurse practitioner here in Milam County; however, that still doesn’t change my opinion on the very important topic of rural healthcare.
Last legislative session, Senator Cesar Blanco of El Paso offered up a bill in the Texas State Senate to eliminate the administrative and financial barriers nurse practitioners face by the requirement of practicing under a supervising physician. Currently, 27 states have already made this move while several others are currently in the process of doing so. In each case, these states have seen the benefits in their rural communities as freeing these nurse practitioners up to practice where they are needed, when they are needed, and for many in the manner of a general practitioner physician, much like most of rural America enjoyed prior to the takeover of most of America’s medical infrastructure by corporate medicine and big pharma.
Currently, in the state of Texas a nurse practitioner must pay the supervising physician in order to practice in the state. Payments that are many times too high and lack any real supervision but amount to simple “mailbox money” for doctors. Many times, these fees are so restrictive that the only option for many nurse practitioners is to work for the large corporate medical facilities which generally do not serve to actually benefit the rural communities of Texas.
In Milam County, we are blessed to have a doctor who is a general practitioner, and we have several private-practice nurse practitioners throughout the county. But we need more. Practitioners who serve our residents in a timely fashion with the care and nurturing that have slowly drifted away with the emergence of big corporate medical facilities and the over-specialization of most doctors today. What we need is more of these qualifi ed nurse practitioners who will come and serve our rural communities as independent General Practitioners.
This session, Senator Blanco along with multiple co-signers has proposed Senate Bill 911, also known as the HEAL Texans Act. Passing SB 911 will create an improved environment for our nurse practitioners, allowing them to meet the needs of not only Milam County, but of rural Texas as a whole. Many of the states who have passed this legislation have done so specifically to open these doors and allow those less-served communities to get the help they need, much like we need in Milam County.
My Great-Uncle George Henry was a small-town family doctor, a general practitioner, in my father’s hometown back in Georgia. He was born in 1922, attended Emory University Medical School in Atlanta, and served his hometown as the town General Practitioner doctor for many years. Many things have changed since that time and to see someone with a medical degree serving as a General Practitioner is extremely rare today. Most doctors today are specialized and work on a referral system rather than being in the business of serving the general needs of the public. And honestly, most scholars admit that with the advancement of technology and science, the nurse practitioners of today are better trained and educated than most doctors were even just 50 years ago.
To date, the only real opposition to this has been big corporate medicine and the Texas Medical Association (TMA) who represent Texas’s doctors. Both over the years have opposed any legislation created that would address medical workforce shortage, improve access to healthcare, and expand the scope-of-practice for non-MDs. Just remember, the TMA is more concerned with protecting the income of their dues paying members (doctors) and their extra income – not you.
So now it’s up to all of us to contact our state representatives and senators and let them know how we feel on this subject. Do we want to continue to yoke our nurse practitioners to unnecessary administrative and financial burdens which greatly limits medical care in the rural parts of our state, or do we want to free these nurse practitioners and allow them to practice where, when, and how they want to help rural Texas reestablish the local healthcare services we need.
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