MAFP Introduces Legislation to Protect Patients by Preserving Physician-led Care Teams in Michigan

Michigan Academy of Family Physicians, as a partner in the Michigan for Advancing Collaborative Care Teams (MiACCT) coalition, has introduced new legislation in the Michigan House of Representatives aimed at preserving and strengthening physician-led, person-centered healthcare teams in our state.

House Bill 4472 requires physician assistants and advance practice registered nurses to practice within a physician-led healthcare team and maintain collaboration and consultation with a physician member of the care team through a written practice agreement. Under the bill, a practice agreement would be required to include:

• A process between the PA/APRN and physician for communication, availability, and decision making when providing medical treatment to a patient; the process must be based on the education, training, and experience of the PA/APRN and physician.
• A protocol for designating an alternative physician leader when the participating physician is not available for consultation.
• The typewritten or printed names and signatures of the PA/APRN and physician.
• A termination provision that allows the PA/APRN or physician to terminate the practice agreement by providing written notice at least 30 days before the termination date.
• A list of the duties and responsibilities of the PA/APRN and physician that fall within their education, training, and experience and are within the scope of their license.
• A requirement that the physician verify the PA’s/APRN’s credentials.
• A process for periodic, join review of patient charts, medical records, and guidelines for collaboration and consultation.
• A process for periodic, joint evaluation of the services delivered to a patient and for physician input when necessary, including, but not limited to, complex clinical cases, patient emergencies, and referrals.
• An evaluation process for measuring performance.

“Michigan Academy of Family Physicians and our members applaud Representatives Alabas Farhat and Mike Mueller for sponsoring this important bipartisan bill to protect patient health and safety, while increasing access to comprehensive care that keeps the patient at the center of their care,” said MAFP President Glenn Dregansky, DO, FAAFP.

“Physician assistants and advance practice registered nurses are valued members of care teams. However, their education, training, and experience is not nearly as extensive or rigorous as that of physicians, who have trained for a minimum of seven years and spent thousands of hours in lectures, clinical study, lab work, and direct patient care during their training. To ensure the safety of patients, it is essential that non-physician providers only diagnose and treat patients under the supervision of and in consultation with physicians.”

Earlier this month, a competing bill was introduced in the Michigan Senate that calls for establishing scope of practice and autonomous practice authority for nurse practitioners. The provisions of Senate Bill 279 pose a risk to patient safety, as they would allow non-physician providers to deliver care independent of physician-led care teams.

As HB 4472 and SB 279 are considered in the Health Policy Committee within their respective chamber, MAFP will continue to support initiatives that maintain physicians as leaders of collaborative care teams and oppose bills that erode the team-based care practice model.