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Kansas nurses try to shake physician contract rule

May 11, 2019

KANSAS CITY, Kan. (AP) — Kansas nurse practitioners are fighting to get rid of the state requirement that they get permission to work from a physician.

Kansas is one of the few states that still makes advanced practice nurses sign contracts with doctors, which physicians argue protect patients by ensuring that nurses collaborate with their more educated colleagues, KCUR-FM reported .

But nurses are fighting back against the contracts, which they say limit patient options and can even give doctors a cut of their earnings for little to no work.

“I want to practice in a state that recognizes our qualities and our academic experience,” said Stephanneth Adams, a nurse practitioner in Kansas who plans to move to Nevada.

The National Academy of Medicine and many public health groups have said there’s little evidence supporting the contracts.

“No studies suggest that (advanced practice nurses) are less able than physicians to deliver care that is safe, effective, and efficient,” the National Academy of Medicine has stated.

“In fact, evidence shows that nurses provide quality care to patients, including preventing medication errors, reducing or eliminating infections, and easing the transition patients make from hospital to home,” the academy said.

A bill seeking to drop the collaborative contract requirement died in a legislative maneuver to expand Medicaid this year.

Nurse practitioners hope to try again, offering to make new nurses work a few years before dropping their contracts with doctors.

Many physicians are pushing to prevent Kansas from scrapping the requirement, saying they’re skeptical of nurses’ independent practice and distrust the Board of Nursing’s oversight.

Some physicians are suggesting that Kansas keep the contracts, but make improvements and protections so that doctors can’t abuse them for financial gain.

“I feel bad for those folks,” said Jeremy Presley, a private practice doctor in Dodge City. “Frustrated for them, that those agreements aren’t in a better — you know, aren’t set up in a better way.”

A recent national survey found that advanced practice nurses are more likely to face contract fees if they work in rural areas or at nurse-operated clinics. The contract prices charged to the nurses or their clinics often topped $6,000 and ranged up to $50,000 annually, according to the study.

The Kansas Advanced Practice Nurses Association surveyed 180 nurses and half said their collaborating physician received monetary compensation from their contract. The costs varied from $1,200 to $16,000 per year.