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Florida Legislature Will Once Again Address Nurse Practitioner Issue

One legislator looking to get the bill through in 2020 is state Sen. Jeff Brandes, R-St Petersburg.

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Look for the Florida Legislature to once again grapple with the issue of nurse practitioners.

Susan Lynch, the CEO of the Florida Association of Nurse Practitioners, said with the physician shortage in Florida, nurse practitioners can help fill the gap for Floridians.

This year, legislation sponsored by state Rep. Cary Pigman, R-Avon Park, would have allowed nurse practitioners to use the full extent of their training. The bill overwhelmingly passed the Florida House but was held up by the state Senate thanks largely to the fierce opposition of physician groups.

One legislator looking to get the bill through in 2020 is state Sen. Jeff Brandes, R-St Petersburg.

Brandes pointed to numerous studies which have concluded that the care provided by nurse practitioners is just as safe and effective as the care provided by physicians. He cited a 2009 analysis of more than two dozen research articles comparing physician and nurse practitioner outcomes which concluded that there are “no appreciable differences between physicians and APRNs in health outcomes for patients, process of care, resource utilization, or cost.”

“The biggest challenge is just getting through some of these physician groups that block this stuff every year. They are pretty happy having the monopoly they have. There’s no big push by them to expand access for patients. For us, the key has got to be the Legislature has got to show some leadership,” said Brandes.

“It’s really about everyone practicing at the top of their scope so that we’re being the most efficient way we can do health care,” Brandes added. “We simply just aren’t going to have a choice. If we have 25 million people in this state and we have a static number of physicians, it just doesn’t work. The math doesn’t work. So really, it’s how do we provide better access and more access?”

The U.S. Veterans Administration (VA), the U.S. Department of Justice, and 24 states and territories give nurse practitioners the recognition to practice independently.

States like Florida, however, require a nurse practitioner to have a contractual agreement with a physician — also known as a “protocol” — in order to practice.  Some physicians take advantage of these requirements and charge upwards of $50,000 a year to sign such an agreement — and, in many cases, the physician never even interacts with the patient.

The Florida Association of Nurse Practitioners noted for the vast majority of patients seeing a nurse practitioner or a physician’s assistant is just fine.

“The real challenge comes in if everybody says ‘oh no, everyone’s got to see a doctor.’ There just aren’t enough physicians to provide that level of service and that’s something that we have to be honest about and take leadership on,” said Brandes.


Reach Ed Dean at




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