The Wisconsin Medical Society (WisMed) hailed Governor Tony Evers’s veto of a bill April 15 that would have allowed certain advanced practice registered nurses (APRN) to provide complex care independent of any physician involvement. In this press release following the Governor’s action on 2021 Senate Bill 394, WisMed Board of Directors Chair Jerry Halverson, MD, DFAPA, emphasized the importance of ensuring the state’s patients have access to physician-led, team-based care:
“There is no substitute for a physician’s rigorous medical school education followed by many years of real-world training and experience,” Dr. Halverson said in the release. “While that’s the level of expertise patients deserve and quite frankly expect, Senate Bill 394 would have encouraged certain nurses to open independent clinics having no physician involvement whatsoever. That’s not wise or safe – and it’s certainly not the way to make sure patients get comprehensive care.”
Governor Evers expressed similar themes in his thoughtful veto message, which also touched on physician groups’ difficulties in reaching a reasonable compromise with various nursing groups and state legislative authors:
“I respect the many people and professions on both sides of this conversation,” Gov. Evers said in his veto message. “Unfortunately, the bill ultimately before me today does not address some of the issues raised by parties in the medical profession that went unremedied during the legislative process. I am therefore vetoing this bill in its entirety because I object to altering current licensure standards for APRNs, allowing practices functionally equivalent to those of physicians or potentially omitting physicians from a patient’s care altogether notwithstanding significant differences in required education, training, and experience.”
Main Legislative Author Vows to Bring Bill Back Next Session
The bill’s main author, State Assembly Rep. Rachael Cabral-Guevara (R-Appleton), told Wisconsin Health News (WHN) after the veto that physicians should be ashamed for standing in the way of her independent nursing bill, and vowed to introduce the proposal again in the 2023-24 state legislative biennium. Rep. Cabral-Guevara, who owns her own clinic in Appleton, is giving up her State Assembly seat to run for a State Senate office being vacated by State Sen. Roger Roth. Rep. Cabral-Guevara also told WHN that she would seek a state legislative override of the veto. While that attempt is technically possible, it would require a two-thirds vote of each legislative body to accomplish an override. That means a successful override vote would require Democrats in each chamber to vote against a governor from the same party; that is extremely unlikely.
You can see Rep. Cabral-Guevara’s post-veto press release here and a video she posted on Facebook the afternoon of April 15.
Physicians Need to Step Up in the 2022 Elections
While the veto of SB 394 is a victory for the state’s excellent health care system, it is far from an action providing permanent impact. Physicians’ grassroots efforts during the SB 394 debate helped ensure bipartisan opposition to the bill in both the State Assembly and State Senate, and direct contacts with Gov. Evers’s office lent support for the eventual veto. Now that the state legislative session is essentially complete for the 2021-22 biennium, physicians can stay involved by making political contributions to WisMed’s Political Action Committee, WISMedPAC. This physician-led entity helps amplify the voice of medicine by supporting candidates and legislative organizations who appreciate what physicians do for their communities and the health of the state. Visit the WISMedPAC page to make a contribution, or start your own political contribution savings account through WISMedDIRECT. Contact WisMed’s Heidi Green for more information about how you can get involved.
For additional information about the SB 394 veto, contact WisMed’s Mark Grapentine, JD.
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