Bill Improves Team-Based Health Care

Texas physicians say decades-old regulations governing the team-based approach to health care can make care inefficient and sometimes inaccessible. New legislation passed by the Texas House today would improve access to care while protecting patient safety by maintaining the current physician-led team model.

Senate Bill 406 by Sen. Jane Nelson (R-Flower Mound) and its companion House Bill 1055 by Rep. Louis Kolkhorst (R-Brenham) replace an outdated system physicians use to delegate and supervise prescribing authority to advanced practice registered nurses (APRNs) and physician assistants (PAs) with one that reflects a more cooperative and efficient approach to team care. The legislation eliminates the differing site-based restrictions and replaces them with monthly quality assurance meetings. Generally, the bill places more flexibility in the hands of delegating physicians but maintains their responsibility for supervision.

Despite the changes reflected in the legislation, “physicians are still the ones who are trained to diagnose and treat, and the statute still places physicians in a supervisory role to ensure patients get adequate, evidenced-based care,” said Fort Worth pediatrician Gary Floyd, MD, a consultant to the Texas Medical Association (TMA) Council on Legislation.

TMA leaders maintain that physicians, because of their extensive medical training, are uniquely qualified to diagnose and treat patients. Without a physician to guide the health care team, patient safety is at risk.

The intent of the bills is to strike a balance between the need for adequate safety controls of high-risk narcotics and for certain patients to get access to the drugs in critical situations. That will benefit physicians and their teams in conducting more efficient care, Dr. Floyd said. More importantly, “the ones who really ought to win are the patients, because this ensures their safety.”

For more on the legislation, check out the May issue of Texas Medicine magazine.