The Oklahoma Legislature on May 29 reversed Gov. Kevin Stitt’s veto of HB 2298, legislation intended to grant full practice autonomy to nurse practitioners who have fulfilled 6,240 hours of supervised practice after completing their training program. A similar measure for physician assistants is currently being evaluated.
This action aligns with a national pattern. Presently, 28 states have conferred nurse practitioners with full practice authority, signifying that these professionals can assess, diagnose, and request diagnostic examinations.
“Nurse practitioners fulfill various essential roles in delivering healthcare to Americans,” remarked Patrick Aguilar, MD, managing director of Olin Business School’s Business of Health Initiative at Washington University in St. Louis.
“They enhance access to healthcare, particularly in regions that are lacking sufficient physician coverage. This is especially pertinent in rural areas like those in Oklahoma, but also applies to urban locations and specialties facing significantly higher demand than what the current supply of physicians and nurse practitioners can manage.”
Nonetheless, a broader dialogue regarding the extent and duration of training and credentialing required to independently care for patients across all categories is essential, according to Aguilar.
“Research has shown that care delivered by nurse practitioners achieves similar safety results to that provided by physicians in multiple studies, yet a significant examination conducted by the National Bureau of Economic Research indicated that nurse practitioners delivered more expensive care accompanied by poorer outcomes,” Aguilar stated.
Uniformity in training is a critical concern. “Training for nurse practitioners is highly inconsistent, with some programs offering structured and validated curricula while others deliver less systematic, ad-hoc training that leaves students heavily reliant on their specific experiences during rotations. Results are likely to vary based on case complexity and distinct training exposures,” Aguilar explained.
On average, nurse practitioners earning a master’s degree in nursing undergo approximately 500 hours of clinical training within their academic program. Those attaining a doctorate complete around 1,000 hours. After finishing these programs, nurse practitioners must pass a board exam that addresses the specific focus of their degree, such as family nurse practitioner, women’s health nurse practitioner, pediatric nurse practitioner, and so forth.
In contrast, physicians generally complete about 5,000-6,000 hours of clinical training by the conclusion of medical school and are required to pass three extensive examinations that cover a wide range of basic and clinical sciences. Moreover, residency programs follow medical school graduation and provide rigorously structured education. Ultimately, physicians typically finish with a minimum of 7,000-8,000 hours of training along with specialty-focused board exams.
“The Oklahoma legislation permits nurse practitioners to commence independent practice following 6,240 hours of supervised practice, which is often inadequately organized and occurs without formal curricular stipulations and additional specialty-specific board certifications,” Aguilar said.
According to Aguilar, patients have the right to be informed about the specific types of training and oversight their healthcare providers have undergone.
“Patients urgently require greater access to healthcare. The crucial question is how to best utilize the skills and capabilities of the workforce to guarantee the safest possible care,” he concluded.
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