”The rules stipulate that nurse practitioners with more than 3,600 hours of clinical practice no longer need to work under a written collaborative agreement with a physician. The required clinical experience equates to about two years in clinical practice. Nurse practitioners with less than the required amount of experience will still be required to work under a physician….”
“The only requirement that remains that will tie experienced nurse practitioners to physicians or hospitals is that they must maintain an established relationship for referral or consultation.”
The rules also let NP’s diagnose illness, and perform therapeutic and corrective measures. Up until Jan. 1, 2015, nurse practitioners could only perform these functions within collaboration with a physician.
The effect of the new rules, besides making primary-healthcare more accessible just by sheer force of added staffing over time, will be to tend to pull down the income of physicians, especially internists and family practitioners. After all, you can train and put to work more NP’s more quickly than you can physicians and NP’s will usually be paid less.
The payers, be they private and public insurers and patients, will see the rise of NP’s as opportunity for more primary care at lower cost. A big question, of course, is how specialized NP’s might also erode the very high compensation of such specialists as cardiologists.