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In Texas, nurse practitioners (NPs) are advocating for legislation that would allow them to practice independently without physician oversight. Texas is 1 of just 11 states that require such supervision. Although the policy proposal still has a long way to go, medical professionals are using the interim to chime in on the pros and cons—including the enhanced capabilities with physician-led care as well as the costs of physician engagement, which could start at $50,000 a year, according to the Fort Worth Report. The Texas Medical Association opposes the change. Nationwide, Washington, D.C., and 27 states allow NPs to practice independently, and 12 other states allow some degree of independent clinical care by NPs without physician supervision. 

Barriers to entry: Practice becomes that much more complex for NPs looking to establish their own clinics. “Even in states that allow independent practice, there are often barriers to a nurse practitioner opening his or her own urgent care,” says Alan Ayers, President of Experity Consulting and Senior Editor of JUCM. “State corporate practice of medicine laws may require physician or hospital ownership of an urgent care facility, banks often require a physician to co-sign or guarantee a loan, and health insurers often require a physician leader to participate in networks.”

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NPs Advocate for Independent Practice in Texas