Special Report: KFDM Investigates Nurse Practitioners
New accusations tonight against an embattled Nederland clinic.
Additional patients are filing complaints against a second nurse practitioner at Optimum Hormone Clinic.
We reached out to that nurse practitioner Randall Locke but have not gotten a response.
Already nurse practitioner Kevin Morgan who owns Optimum has had his nursing license temporarily suspended, pending a hearing.
The Texas Board of Nursing says Morgan's prescriptions put 12 patients at risk and may have contributed to two deaths.
It raises concerns among some doctors about nurse practitioners.
KFDM/Fox 4's Angel San Juan investigates both sides of the debate.
We spoke with doctors who in light of what's happening with Optimum say nurse practitioners in Texas have too much authority and not enough oversight.
But a spokesperson for the Southeast Texas Nurse Practitioners group disagrees, saying there are bad apples in all professions and that nurse practitioners are filling a need.
The flu is widespread across the nation, keeping nurse practitioners busy.
Gwen Verchota is a nurse practitioner at Virtuwell, an online provider of medical advice and care.
If you're sick, you can create an account and then share your symptoms with a licensed nurse practitioner who advises you what to do next.
"There's definitely a need for additional providers, we're hoping to fill in the gap, we're certainly not trying to replace doctors, many of them are part of the teams that we're part of to provide care to patients and sometimes we can fill in the gaps like I said in those areas that may not have MD's close by," says Joe Dodd, a community liaison with SET Nurse Practitioners' Group.
Nurse practitioners are common in rural communities where doctors are scarce, but they're becoming more prevalent in more urban areas.
"As long as there are not enough family practice doctors getting into that field, the gaps got to be made up somewhere," says Dodd. "I think there are plenty of NP's out there the provide those services."
Optimum is a hormone therapy clinic in Nederland run by two nurse practitioners.
The Texas Board of Nursing has temporarily suspended the license of Kevin Morgan, a nurse practitioner, who owns the clinic.
The board says Morgan's prescriptions for testosterone and thyroid hormone put 12 patients at risk and may have contributed to two deaths.
"I think it would be disingenuous for physicians to say that this is a reason why NP's need more supervision because there's always going to be these cases," says Dodd. "It would be a pretty broad brush to paint all NP's or use that as a basis to limit our practice."
Twenty-two states and the District of Columbia have approved "full practice" status for nurse practitioners.
The provision allows them to assess, diagnose, interpret diagnostic tests and prescribe medications independently.
However, that's not the case in Texas.
"We have to have a supervising physician. I believe the new change to the law says that a physician can supervise up to seven NP's sometimes that may or may not require the physicians (being) on site," says Dodd.
Critics argue it's unlikely any real supervision occurs with that ratio.
Optimum has several supervising doctors.
KFDM reached out to two of them but neither would not answer our questions, and one doctor told us not to call back.
Dodd believes nurse practitioners know when to reach out more on behalf of patients.
"I think most nurse practitioners are good at identifying what their limits are and certainly getting the patient additional expertise whether they may be going to the emergency room or collaborating with their supervising physicians," said Dodd.
He says nurse practitioners are restricted in a lot of ways they shouldn't be.
A patient with bronchiolitis may need a nebulizer, but I can't sign for one, or any type of medical equipment I have a patient that I see that has cerebral palsy and needs urinary catheter I have to get a physician to sign for things, those things are kind of silly, and I always thought as a nurse it was kind of silly that a Justice of the Peace with no prior medical experience can pronounce someone dead but me as a nurse when I was an RN couldn't," Dodd said.
There's no doubt a turf war is underway between doctors and nurse practitioners, but Dodd says it's a battle that does not need to be waged.
"At the end of the day, we all want to take care of patients," he said. "We all want patients to get access to the care that they need."
A major contrast between doctors and nurse practitioners is the amount of formal education required.
But five separate studies, including one done by UTMB in Galveston concluded nurse practitioners expand access to care, improve patient health outcomes, boost rural health care, lower primary care costs and reduce emergency room admissions.
Nurse practitioners continue to attract recognition having appeared four times on the U.S. News and World Report list of 100 best jobs. In the most recent ranking, nurse practitioner is third on the list of best jobs.