Posted October 28, 2009
The Nevada Interscholastic Athletic Association (NIAA) recently announced its intention to stop recognizing sports physicals performed by NPs and PAs. The change in regulation is scheduled to take effect in spring 2010. According to the NIAA's interpretation of Nevada statute, the only acceptable signatures will be those of physicians and homeopathic physicians.
NIAA executive director Eddie Bonine wrote a letter to Nevada schools to inform them of the change: "In light of difficulties this past practice has presented as to fall 2009 clearance, I am authorizing recognition of [nurse practitioners and physician assistants] to administer physicals for the 2009-2010 fall participation season only."
The NIAA met in September in Las Vegas and discussed this issue. The Special Practice Group (SPG), an advanced practice nursing group of the Nevada Nurses Association, sought volunteers to attend and speak on behalf of NPs.
"There is a strong need for us to step up here; this will affect us professionally and have a profound impact on our patients," said Tomas Walker, cochairman of the SPG. "Most of us have routinely done this work, and in many circumstances we were the only ones available to provide these services."
Walker said he has performed school and sports physicals since he started practicing as an NP in 1996. "There was never an issue. In the family practices I worked in, the NPs always did the school physicals. The school board in one rural district always contacted us directly to set up a couple of physical days so we could get them all done."
Walker believes the rule change was simply an oversight. "Frankly I don't see it standing." With the deficit in primary care in Nevada, removing NPs' ability to perform sports physicals creates an untenable demand, he said.
According to Diane McGinnis, NP, who attended the NIAA meeting, special arrangements were made to ensure that the NPs and chiropractors in attendance could speak. "One of the NPs from the health department testified that she does athletic participation physicals as part of her position at the health department," she said. Other testimony provided information about the many physicals NPs have safely performed. Many other providers testified that NPs perform these physicals safely, and sometimes are the only providers in a county to perform them.
Bonine said during the meeting that the board would consider using an expedited emergency procedure it can follow to make changes to regulations. Otherwise, a change could take more than a year to implement. He told the NPs that if they had patients to see that day for physicals, they should still see them.
"The executive director of the board also asked NPs to get the word out to the various state representatives and senators that we were looking for expedited approval and to be expecting the request," McGinnis told ADVANCE. "This is where we as NPs must step up to the plate and make a grassroots effort to inform our (and everyone else's) state assemblypersons and state senators what needs to be done ASAP!"
McGinnis also said that several of the testifying NPs volunteered to be members of the NIAA's medical provider advisory committee and to help expedite the changes in regulation.
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