PHYSICIAN ASSISTANTS: Writing More Prescriptions

      The "increased legal authority" of the nation's 34,000 physician assistants and 60,000 nurse practitioners to write prescriptions, combined with a growing acceptance of their purview by physicians, is resulting in a dramatic jump in the number of prescriptions they write, the AP/New Orleans Times-Picayune reports. In 1998, nurse practitioners wrote 15 million prescriptions, up 66% from 1997, while physician assistants wrote 12 million, up 33%. American Medical Association President Dr. Thomas Reardon said, "The increase in scripts reflects the increasing numbers of nurse practitioners and physician assistants working with doctors." All but Louisiana, Mississippi, Indiana and Ohio permit physician assistants to write prescriptions, while all states grant nurse practitioners the authority to order prescription drugs. However, in Pennsylvania, Georgia, Michigan and Ohio, doctors must co-sign nurse practitioners' prescriptions and in some states nurse practitioners and physicians assistants are prohibited "from ordering highly addictive drugs or controlled substances." Proponents of the trend note that granting these caregivers whose specialties began in the 1980s more authority "makes doctors available to work on more complex cases and saves patients time, too." Opponents, however, allege that "these caregivers lack enough education to prescribe medicines." Although all states require physician supervision of their assistants and most states require the same for nurse practitioners, Oxford Health Plans allows "its New York City members [to] choose a nurse practitioner as their primary caregiver." Bill Kohlhepp, a physician assistant in New Haven, CT, said, "Physicians used to look at prescribing drugs as the one thing that separates them from other people. They initially thought they would be giving something up. This is positive for the patients. Prescribing drugs is part of practicing medicine" (Galewitz, 8/17).