North Carolina is one of 12 states with the strictest laws governing how and to what extent nurse practitioners can run their own practices, and the state is facing increased scrutiny as experts point to NPs as a potential solution for primary care shortages, according to The Laurinburg Exchange.
Under current laws, NPs in North Carolina must pay a supervising physician thousands of dollars per year to stay in business. They also must meet with the supervisor twice a year, and they have 30 days to find a new supervisor if they lose the one they have.
In contrast, 22 states, the District of Columbia and federal government facilities allow NPs to practice without physician supervision. North Carolina NP groups have pushed to remove the restrictions through the SAVE Act, which is still under consideration.
The Federal Trade Commission has called the regulations anticompetitive. "They effectively give one group of healthcare professionals the ability to restrict access to the market by another, competing group of healthcare professionals, thereby denying healthcare consumers the benefits of greater competition," the FTC said in a 2014 report.
But many physicians argue the supervision is necessary to ensure patient safety. "There's no substitute for the extensive education and training of physicians," the North Carolina Medical Society said. An NP typically has 13,500 fewer hours of clinical experience than a family physician, according to the Primary Care Coalition.