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The Hospital and Healthsystem Association of Pennsylvania has come out in support of a proposal that would allow nurse practitioners to operate independently from doctors. Supporters say it would help offset a shortage of doctors and increase access to health care in rural and economically-distressed areas.



Nurse practitioners are registered nurses with additional training and degrees in specialized areas. They can do many of the things done by family doctors, such as diagnose illnesses, order and interpret medical tests, and prescribe medications.



But in Pennsylvania, they are required to have a formal agreement with two doctors that puts them under the doctors' supervision. In 21 other states, nurse practitioners are allowed to operate independently, meaning they can set up their own practice and provide most of the care people normally get from a family doctor.



State Sen. Pat Vance, R-Cumberland, last year introduced a bill that will allow nurse practitioners to work independently. The HAP-endorsed measure is a compromise that would enable them to do so after three years and 3,600 hours working under the kind of collaborative agreement with a doctor Pennsylvania has long required.



"Allowing full practice authority for CNPs after meeting the appropriate physician collaboration requirements is a reasonable, responsible approach to helping to meet the growing health care needs for Pennsylvania," said HAP CEO Andy Carter.



However, the Pennsylvania Medical Society opposes the change, saying the connection to the doctors is critical when nurse practitioners run into situations beyond their training. "We still believe patients deserve that extra level of patient safety," spokesman Chuck Moran said.



Moran pointed to a 2015 poll commissioned by the medical society which found that only 15 percent of respondents believe nurse practitioners should be allowed to practice independent of doctors.



Vance, a former nurse, has been pushing to allow nurse practitioners to work independently since 1999. She has long characterized the issue as a "turf war" between doctors and nurses.





She said she supports the compromise, which will come in the form of an amendment to her bill authored by state Sen. Lisa Boscola, D-Lehigh.



"I think that's hopefully what we need to get this things finished," Vance said. But she declined to predict the likelihood of the bill's passage.



Nurse practitioners say they place a strong emphasis on things like spending enough time with patients to educate them about their illnesses and needed lifestyle changes.



Vance said the bill will result in "more instant access to health care, particularly in rural areas, particularly for seniors ... I just don't see the downside."