Kansas Becomes 26th State to Loosen NP Practice Restrictions


Nurse practitioner jobs in Kansas now offer a bit more freedom thanks to a bill recently signed into law by Governor Laura Kelly. The bill eliminates the need for direct supervision among nurse practitioners looking to provide the primary care they are trained and licensed to perform. Kansas is the 26th state to make the change. Two U.S. territories and the District of Columbia have also given greater practice authority to NPs.

 Will the remaining twenty-four states follow suit? That’s hard to say. A similar bill was defeated in Colorado in early 2022. In other states, legislators are not even having the discussion. Whether or not to sever the supervisory relationship between physicians and nurse practitioners is by no means settled.

 Independent Primary Care

 Prior to the new law, Kansas nurse practitioners were allowed to offer primary care under the supervision of a physician. An NP could work in the supervising doctor’s office or, with a written agreement in place, offer care in a separate facility. In either case, the NP’s scope and practice remained subject to doctor supervision.

 Such restrictive scope and practice laws have been common in the U.S. for decades. However, the COVID pandemic made it clear that NPs and their physician assistant counterparts are more than capable of providing quality primary care without being tethered to a physician. Perhaps that’s why just over half the states have since loosened their restrictions.

 The most intriguing aspect of eliminating direct supervision is its potential impact on nurse practitioner jobs. How will NPs choose to practice in states that don’t require it?

 Retail Primary Care

 A recent Forbes article by Senior contributor Bruce Japsen briefly mentioned the proliferation of retail healthcare clinics operated by well-known companies like CVS. The retail health clinic is nothing new, but it has gained widespread attention thanks to the pandemic. Such clinics are prime candidates for independent nurse practitioners.

 Japsen suggests that patients could be willing to seek primary care from a nurse practitioner in a retail clinic if that meant avoiding crowded doctors’ offices and long waits in the waiting room. It is hard to argue his point. Anyone who has sat waiting an hour or more for the doctor, only to be given 10 minutes of their time, might welcome the opportunity to walk into a retail clinic, see the NP, and be out the door in under 30 minutes.

 Of course, not all retail clinics get patients in and out as quickly. But the advantage of the retail model is that nurse practitioners are not bound by tight scheduling. They can see fewer patients in a day and, as a result, spend more time with each patient.

 Not Everyone on Board

 It is clear that not everyone is on board with the idea of loosening restrictions on nurse practitioner jobs. There are doctors and healthcare groups who don’t feel as though NPs have enough training to work independently. There are also patients who just do not feel comfortable visiting with an NP – especially if a doctor is available.

 Efforts to prevent states from cutting direct ties between physicians and nurse practitioners is to be expected. Healthcare is a very touchy subject for obvious reasons. Therefore, wide differences of opinion are part of any debate. Furthermore, such differences are not always worked out as evidenced by the fact that there are still twenty-four states that require physician supervision of nurse practitioners in primary care settings.

 Such supervision is no longer necessary in Kansas. With the new law in place, Kansas joins twenty-five other states in allowing nurse petitioners to practice independently.

by Tim Rush (CEO HSI, LLC)

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