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The American Medical Association (AMA) frequently cautions against certain expanded scope-of-practice allowances for nurse practitioners (NPs) in everyday patient care. In a new post, AMA points to a study in Family Practice that examined whether NPs in Florida are practicing within the state’s requirement, which stipulates that autonomous NPs must work within primary care. Since the passage of an expanded scope-of-practice rule in 2020, Florida has allowed NPs who complete at least 3,000 clinical practice hours to see patients without direct physician oversight—but only within primary care. Among 328 NP practices randomly sampled and analyzed in the study, only 39% were providing primary care, while 59% were practicing in non–primary care clinical settings. The most common specialties outside of primary care included cosmetic or med spa services (eg, antiaging, IV hydration, etc.) and psychiatry or addiction medicine. Just 20 of NPs sampled were practicing in emergency medicine or urgent care. Additionally, only 16.7% of NPs who moved to Florida after the policy change entered primary care roles, according to AMA.Â
Overarching goal: Overall, the study suggests there is likely a gap between policy rules and actual workforce behavior. Florida’s goal was to increase access in primary care, which AMA says is still a struggle in the state. Because urgent care falls outside the defined primary care categories, autonomous practice authority for NPs does not extend to urgent care settings. More than 284,700 active NPs practice in the United States, and an estimated 32,000 practice in Florida, according to Becker’s.