North Carolina’s current health care system is built on a team-based model that includes physician leadership—an approach designed to ensure high-quality care, improve outcomes, and control costs.
APRN Definitions/SAVE Act (HB 514/SB 966) would remove physicians from the patient care team. This change raises serious concerns about both patient safety and the overall cost of care.
Why Does Physician Involvement Matter?
Physicians receive significantly more education and clinical training than other health care providers, uniquely preparing them to diagnose complex conditions, coordinate care, and make high-stakes medical decisions. Removing that level of expertise from the care team can lead to unintended consequences.
What Does the Research Show?
A growing body of research suggests that reduced physician involvement may lead to increased utilization and higher costs:
- A 2020 study in the Journal of General Internal Medicine found that nurse practitioners in less restrictive practice environments were significantly more likely to prescribe opioids at higher rates.
- A study published in the Journal of the American College of Radiology found that imaging orders by non-physician providers increased by more than 400% over time—raising concerns about unnecessary testing, higher costs, and increased patient exposure to radiation.
- Research from the National Bureau of Economic Research found that, compared to physicians, nurse practitioners used more health care resources, including longer lengths of stay and higher overall costs, while achieving less favorable outcomes on certain measures, such as preventable hospitalizations.
Protecting Patients and Managing Costs
These findings underscore a clear point: physician involvement is a critical safeguard for both patient safety and cost-effective care.
North Carolina’s current law ensures that physicians remain engaged in patient care. Preserving this physician-led model helps patients receive accurate diagnoses, appropriate treatment, and coordinated care—while avoiding unnecessary costs.
As policymakers consider the APRN Definitions/SAVE Act, maintaining physician leadership on the care team remains essential to protecting patients and ensuring a high-quality, efficient health care system.