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Patient access to MRIs, CT scans to be eased by new state law, nurses say

Advanced practice registered nurses now are authorized under Georgia law to order radiologic procedures, following Gov. Brian Kemp's signing of Senate Bill 321. Credit: Erin! Nekervis / CC BY-SA

By David Pendered

Patients may find wait times are shorter to get orders for an MRI and similar procedures following Gov. Brian Kemp’s decision to back nurses over doctors and allow nurses with certain credentials to order radiologic tests.

The signing ceremony of Senate Bill 321 culminated an eight-year effort by nursing organizations. The attendees include (left to right): Tom Bauer, lobbyist; Michelle Nelson, CAPRN co-director and UAPRN state president; Julianna McConnell, CAPRN lobbyist; Rep. Randy Nix; Gov. Brian Kemp; Amy Reeves, secretary, Georgia Association of Physician Assistants; Rep. Alan Powell; and Sen. Chuck Hufstetler. Credit: Gov. Brian Kemp’s office

Patients no longer have to wait to see a doctor to get an order for an MRI or other radiologic procedure. Previously, state law authorized only doctors to order radiologic imaging tests, with one exception: Advance practice registered nurses could order such tests only in the case of “an emergency situation in which a patient’s life or physical well-being will be harmed if certain testing is not performed immediately.”

These tests now can be ordered by advanced practice registered nurses, following the governor’s signature on Senate Bill 321.

This category of nurse may be required to have a masters degree, and some have doctorate degrees, according to a report by the federal Bureau of Labor Statistics.

The field is well-paid, and expected to grow by 28 percent by 2020 – compared to 5 percent growth for all occupations. Median salaries in 2019 were almost $116,000 a year for positions sometimes titled as nurse anesthetists, nurse midwives, and nurse practitioners, according to BLS.

Authority to order radiologic procedures has been a perennial battle between nurses and doctors since 2012. Such turf wars among medical personnel are not uncommon at the Georgia Legislature, especially as the stakes continue to rise in relation to the cost of health care.

Nurses’ organizations portray their desire to order radiologic tests in terms of improving patients’ access to healthcare.

“The bill will allow APRNs to provide more quality, cost-effective patient care,” Lisa Wright Eichelberger, dean of Clayton State University’s College of Health, said in a statement.

Advanced practice registered nurses now are authorized under Georgia law to order radiologic procedures, following Gov. Brian Kemp’s signing of Senate Bill 321. Credit: Erin! Nekervis / CC BY-SA

Michelle Nelson sounded a similar note. Nelson serves as co-director of the Coalition of Advanced Practice Registered Nurses and as state president of the United Advanced Practice Registered Nurses of Georgia of Georgia. Nelson addressed the radiologic issue as one of many where she thinks advanced nurses could take on more treatment responsibility:

  • “Historically, these restrictions have caused unnecessary delays in patient care, as well as increased medical costs for patients. Now, with the pandemic raging, we have the additional challenge of many Georgia APRNs being hired away by other states where they are not as restricted, which is causing further hardships for Georgia patients.
  • “We applaud our state legislature and Governor Kemp for recognizing the crucial healthcare services and patient care APRNs provide, and for taking the first step in lifting the restrictions under which we have been forced to operate.”

Doctors’ organizations contend otherwise. Allowing nurses to order such tests will open the floodgates to expensive procedures that could endanger patients, according to a July 15 letter sent to Kemp by the CEO/executive vice president of the American Medical Association:

  • “The AMA is concerned such expansion will increase health care costs and threatens the health and safety of patients in Georgia. For these reasons we strongly encourage you to veto S.B. 321.”

The letter from Dr. James Madara continued:

  • “All health care professionals play a critical role in providing care to patients; however, their skillsets are not interchangeable with that of fully trained physicians. While nurse practitioners are valuable members of the health care team, with only two to three years of education, no residency requirement and approximately 500-720 hours of clinical training, they are not trained to practice independently. By sharp contrast, physicians complete four years of medical school plus three to seven years of residency, including 10,000-16,000 hours of clinical training. Patients in Georgia deserve physicians leading their health care team.”

The Medical Association of Georgia had flagged the measure as a piece of “key health care legislation” the organization tracked during the session. MAG did not state in this location the reason for its opposition.

In terms of the politics of getting the measure passed, the House added it to a Senate bill and the Senate agreed, according to various versions of the bill.

Kemp did not indicate his thoughts on the legislation. The governor did not issue a statement about the bill, which is common practice.

 

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David Pendered

David Pendered, Managing Editor, is an Atlanta journalist with more than 30 years experience reporting on the region’s urban affairs, from Atlanta City Hall to the state Capitol. Since 2008, he has written for print and digital publications, and advised on media and governmental affairs. Previously, he spent more than 26 years with The Atlanta Journal-Constitution and won awards for his coverage of schools and urban development. David graduated from North Carolina State University and was a Western Knight Center Fellow.

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