Posted on December 12, 2020
Mississippi limits the ability of nurses to practice until they are fully trained – so-called “complete practice autonomy.” In particular, nurses who wish to open their own practice or an independent clinic must enter into a cooperation agreement with a doctor. The agreement provides for the attending physician to be within 75 miles of the nurse`s site. The attending physician is then required to randomly check up to 20 patient cards from the nurse and meet with the nurse once a quarter. The typical fee for this minimum test standard (not in real time) is $74 per day or $2,250 per month. The proposed regulations remove the concept of “independent clinic” and stricter admission requirements for independent clinics, and instead provide that “physicians are prohibited from entering into cooperation agreements with NRPAs whose site is located more than 75 miles from the primary office of the physician. … A collaborative physician must always dissolve within 75 miles of the APRN. Physicians should also answer co-operation questions during the first licence and during each annual renewal cycle, with changes to the membership status to be notified to the Board within 10 working days. For this reason, 24 states and the District of Columbia are expanding full practice power to nurses, which means nurses can independently evaluate and treat physician patients. Thus, the proposed regulations, if adopted, would allow nurses to practice up to 75 miles from the primary office of their cooperating doctors, and would provide more flexibility for nurses – as in rural areas – who have struggled to find a suitable cooperating doctor within 15 miles of their practice under current rules. Many studies show that nurses provide care at least as good as doctors, with some studies showing even better results.
This can be explained in part by the fact that nurses are both cheaper and more easily accessible, especially for low-income patients. Other evidence suggests that nurse practitioners tend to follow recommendations more frequently and spend more time with patients – practices associated with better patient outcomes. Currently, nurses must practice in collaboration with a physician. This would free them from this requirement after working 3,600 hours. Collaboration with a supervisor is necessary and written practice guidelines must be developed between the physician and the NP. The agreement must include the availability of the co-operative physician for consultation or referral, or both methods of managing collaborative practice, which includes guidelines for clinical practice, and coverage of a patient`s health needs in the absence of a registered nurse or physician. The Board of Care must approve the protocol to ensure compliance with regulatory standards. Mississippi Nursing Practice Act 73-15-20 (3) Free Standing Board regulations define an “independent clinic” as a clinic or other facility (except hospitals and some other specialized facilities) where patients are cared for by a nurse located more than 15 miles from the primary office of the physician/counsellor. Physicians who wish to work or advise with a nurse practitioner in an independent clinic must currently obtain special agreement from the board of directors, which requires, among other things, that the physician appear in person or by telephone in front of the board. The surveillance system must be approved by the Mississippi State Board of Medical Licensure.