It was a moment 37 years in the making, and it came not one minute too soon, says Julie Stanik-Hutt, PhD, ACNP/GNP–BC, a staunch supporter of a new Maryland law that frees nurse practitioners to better serve rural and underserved areas of the state. The law removes a mandate that nurse practitioners maintain “attestation agreements” with physicians as a pre–condition of licensing, meaning where there were no physicians there could be no nurse practitioners.
“The change will be invisible to most people,” says Stanik-Hutt. “It won’t be invisible to us, or to our patients. It doesn’t change what an NP does. We’re licensed and legally authorized to prescribe the same medications as physicians in Maryland [the 21st full-practice authority state]. We’re already responsible for the decisions we make. We are already the ones held liable. It just removes the legal requirement for oversight.”
To illustrate the conundrum under the old law, Stanik-Hutt told the story of a nurse practitioner friend in New York State, which had a similar law. The NP practiced with her husband, a physician. One day, he was struck by a car and killed. In a flash, the NP lost her husband, his income, her income (there was a 60-day minimum waiting period to replace a co-signer, meaning she could not practice), and patients lost their providers.
As for Maryland, Stanik-Hutt says the effort got a big push about a decade ago when the American Association of Retired Persons joined in, fearful that there were not enough providers to care for its older members in the state. From there, it kept building momentum.