A Breakdown of Advanced Practitioner Autonomy in the United States

A recent survey found patients welcome physician assistants and nurse practitioners to have a larger role in their care, but the country remains splintered, as 24 states still require physician involvement in diagnoses and treatment.

The following information is from the Kaiser Family Foundation's State Health Facts and was compiled from "The 2012 Pearson Report" from The American Journal for Nurse Practitioners.

A requirement for a physician's relationship with a nurse practitioner may vary from collaboration to supervision, authorization, delegation and/or direction. This data is separate from that pertaining to requirements for physician involvement in prescribing.

States that do not have a requirement for physician involvement in diagnosing and treating patients

Alaska
Arizona
Arkansas
Colorado
District of Columbia
Hawaii
Idaho
Iowa3
Kentucky
Maine4
Maryland5
Massachusetts
Michigan6
Montana
North Dakota
New Hampshire
New Jersey
New Mexico
Oklahoma
Oregon
Rhode Island
Tennessee
Utah
Vermont
Washington
West Virginia
Wyoming

States that do have a requirement for physician involvement in diagnosing and treating patients

Alabama
California
Connecticut2
Delaware
Florida
Georgia
Illinois
Indiana
Kansas
Louisiana
Minnesota2
Mississippi
Missouri
Nebraska
Nevada
New York
North Carolina
Ohio
Pennsylvania2
South Carolina
South Dakota
Texas
Virginia
Wisconsin

1 For adult nurse practitioners
2 Requirement for physician involvement but no requirement for written documentation of relationship
3 For advanced registered nurse practitioners
4 After first two years of practice
5 After signing Board of Nursing Attestation Plan promising collaboration
6 Nurse practitioner functions under Public Health Code definition of nursing

More Articles on Advanced Practitioners:

Survey: Physicians Oppose Expanding Advance Practice Nurses' Role
5 Top Drivers of NP, PA Job Satisfaction
Temporary Staffing Requests for PAs, NPs, on the Rise

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