Eliminating Supervision of Nurses Won’t Improve Access to Care in Rural NC

The NC Coalition to Protect Patients supports team-based healthcare. To protect patients, the healthcare team must be led by those with the highest level of training – physicians.

SB 695/HB 807 would end physician supervision of many types of nurses and fragment the healthcare team. Supporters of these bills say that, once unsupervised, nurses will relocate from the urban areas to rural communities and expand access to health care. This is a false and dangerous promise.

The American Academy of Nurse Practitioners reports that only 18% of Nurse Practitioners practice in rural areas.

North Carolina’s supervision requirement protects patient safety – it does not prevent nurses from practicing in rural or underserved areas.


Current law requires that supervising physicians and nurse practitioners work as a team and be continuously available to one another for consultation via direct communication or telecommunication and that a written plan is developed for performing various medical tasks, prescribing medications and handling emergency situations.

Although supervised, in North Carolina there are no limits on nurse practitioners in regard to geography or practice location. In states that have authorized the independent practice of nurses, neither access to care nor the cost of care has substantially improved.

There is no evidence that eliminating the safeguard of physician supervision will improve access to medical care in rural North Carolina.

Physicians are the number one provider of primary care services in North Carolina’s rural counties. Even in NC counties containing federally designated Health Professional Shortage Areas, Primary Care Physicians outnumber nurse practitioners by more than 2,600.

In fact, eliminating physician supervision of nurses is more likely to harm patients in all areas of our state. Current administrative rules require supervising physicians and nurse practitioners to continually work together to evaluate the quality of the care provided to their shared patients and to create plans to improve clinical outcomes.

SB 695/HB 807 eliminates the Quality Improvement Process currently in place between doctors and nurse practitioners.

This puts patients at risk for unnecessary, adverse outcomes – no matter where they live.

For these reasons, the Coalition opposes SB 695 and HB 807.

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