Action Required: SB 593 Hearing Scheduled for 2/19/20 10am

NHNPA believes SB 593 should not move forward. Any NP who serves as a PCP and has ever signed their name above the descriptors “Physician” or “Primary Care Physician” to certify any form for a patient should be concerned. If this bill passes, the Board of Medicine (BOM) could sanction APRNs accused of representing themselves as practicing medicine. We are in the process of preparing testimony for the hearing on 2/19 and are in need of relevant stories from our membership. Remember our voice is stronger when we stand together!

How you can help

1) Click here to share any stories or examples of the following:

  • If you or any agency uses a term listed in the bill to describe your practice.
    • The possible unintended consequence of legislating terminology. For example:

      • Have you are referred to as a ‘primary care physician’ ie insurances, hospital listings of providers, etc?

      • Have you ever signed health forms, orders for OT, PT, home care, etc that note ‘physician’ or ‘primary care physician’ on a signature line (when you know that you are legally authorized to sign)? How would fear of sanctions from the Board of Medicine affect your practice? 

    • Stories or feedback you provide will be summarized and submitted with NHNPA’s testimony to help kill this bill. 

2) Attend the hearing, to show your support by signing in on 2/19/20 at 10am in Concord. Please click here to let us know you will be coming.

  • We are developing our plan for testimony and believe that it will also be helpful to member sign-in to demonstrate support.

3) Look for additional Calls To Action over the next week.

  • We are working on a broader strategy including outreach to committee members and will be in touch next week. 

Learn more about SB 593

You can review SB 593 here: 

  • The specific terms noted within the bill are surgeon, medical doctor, doctor of osteopathy, M.D., D.O., anesthesiologist, cardiologist, dermatologist, endocrinologist, gastroenterologist, general practitioner, gynecologist, hematologist, internist, intensivist, laryngologist, nephrologist, neurologist, obstetrician, oncologist, ophthalmologist, orthopedic surgeon, orthopedist, osteopath, otologist, otolaryngologist, otorhinolaryngologist, pathologist, pediatrician, primary care physician, proctologist, psychiatrist, radiologist, rheumatologist, rhinologist, and urologist. 

Key Points

  • This bill implies that APRNs are representing themselves as practicing medicine. APRNs are licensed by the Board of Nursing (BON) to provide healthcare services including assessment, diagnosis, and treatment including prescribing. We are unaware of any APRNs representing themselves as practicing medicine or pursing a desire to do so. 

  • CRNAs are APRNs who are trained, often at the doctoral level, and licensed to independently administer anesthesia. According to the NH Board of Nursing (BON) CRNAs are able to use the term “nurse anesthesiologists” as it clarifies their practice. If this bill passes CRNAs who use this term would be sanctioned.

  • NHNPA is strongly opposed to this bill because the legislature is not the appropriate venue to discuss APRN titles and terminology. The BON is the agency that APRNs are licensed through and should continue to be the body that regulates their practice. 

  • This bill seeks to legislate terms for the exclusive use of physicians. The intention is to separate physicians from APRNs as the only providers of healthcare. We are critical providers of healthcare with 2600 APRNs in NH; 75% of these are in primary care serving as ‘primary care providers.’ 

  • If APRNs are sanctioned for ‘representing themselves as practicing medicine’ with the above descriptors, the provision of services could be affected. If suddenly unable to sign forms with a signature line that reads, ‘physician,’ ‘general practitioner,’ or ‘primary care physician’ (all explicitly in the bill) unless licensed by the BOM,  it will seriously impair access to care and result in unnecessary barriers for citizens in NH.  


Kerry Nolte - Chair Gov Affairs Committee

Christina Ferreri - NHNPA President, NHNPA

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