AUGUSTA, Ga. (WRDW/WAGT) – Nurse practitioner-owned clinics across Georgia could be forced to close after a state board ruled last month that they can no longer pay supervising physicians.
In Georgia, nurse practitioners need a supervising physician to provide care to a patient. For years, practitioner-owned clinics have paid doctors for that service. But Georgia’s Composite Medical Board ruled last month those clinics can no longer pay those doctors at all.
Without a doctor, there is no clinic.
Mental health clinic faces uncertain future
Global Mentality Incorporated, an Augusta mental health clinic, serves between 200 and 250 patients. The clinic was built to address a shortage of mental health providers.
“There is a shortage of mental health providers,” said Dr. Kimberly Natson, a psychiatric mental health board certified nurse practitioner at Global Mentality Incorporated. “So I thought by opening a clinic, I would be able to provide more services to more clients.”
Ebony Story, a psychiatric mental health nurse practitioner at Global Mentality Incorporated, said the clinic wants to make sure it can care for neighbors in the community.
Patients call to set an appointment or are referred to the clinic. During an initial assessment, the practitioners figure out what is going on and how to best provide services or resources.
“As those psychiatric mental health nurse practitioners and board certified, we are able to diagnose them and be able to prescribe the medications necessary to treat whatever disease process they have going on,” Story said.
The state medical board now says payment to supervising physicians in any form is prohibited.
The board now says payment to supervising physicians in any form is prohibited.
“We’re just uncertain right now exactly what the ruling really means, how many of our patients are gonna be cut off from care,” Story said.
“If we have to close, what do we do with our clients? What do our patients do? There are not enough providers now to take care of our clients,” Natson said. “It limits access to care, and it means that we can’t serve clients in our own backyard. Georgia is home. This is our family, and if I’m not able to actually have a collaborating physician, I can’t serve my clients.”
Story said the ruling does not give the clinic time to help patients get access to care.
“If they tell us to close our doors tomorrow, we don’t have the opportunity to be able to make sure those patients have access to care,” Story said.
Collaboration still valued
The practitioners said they want to collaborate with physicians, not be restricted based on who owns the practice.
“I think that people think we don’t want a collaborating provider. We both have great collaborating providers that we talk to each month,” Story said. “We want to be able to collaborate, not be restricted where it matters who owns the practice.”
Natson said she would still reach out to a collaborating physician whether she was practicing independently or not.
“It’s just sad that we’re here because we do want to collaborate. We like being able to have a conversation with our medical doctors,” Natson said. “Whether we were in a restrictive state or not, I would still reach out to my collaborating physician whether I was practicing independently or not. It’s something that I would still do.”
But Natson said if nurse practitioners cannot pay collaborating physicians, the majority of them are not going to collaborate.
Patients could face longer wait times
Right now the clinic is able to see patients within a week. If the clinic closes, it could be 30 days or 60 days before a patient is seen.
“If someone’s in a mental health crisis, that’s a long time to be seen,” Story said. “It definitely delays their ability to be helped.”
The clinic is still seeing patients, but the uncertainty follows them into every appointment.
Call for patients to speak up
Natson said nurse practitioners are standing together and asking patients to let lawmakers know how important it is to be seen by a nurse practitioner.
“We need you guys to speak up,” Natson said. “Speak up and let people know what’s going on, because at this point in time, we’re at risk. Your ability to see us may, in the future, may not be a possibility.”
Story said the issue affects more than psychiatric nurse practitioners.
“There’s power in numbers, and we need every patient that not only we service, but any of your nurse practitioners in the area, because it’s not just psych. If you have a midwife, if you have any type of provider who is providing care for you outside of big facilities, they’re gonna be affected,” Story said.
“Ultimately, this is not a fight between the nurse practitioners and the medical doctors. At the end of the day, it’s not about money for us, it’s about access to care,” Natson said.
Filling a gap in care
Both practitioners have doctors and nurse practitioner degrees, which means they did service gap projects. The need for psychiatric care in the CSRA was part of their project in 2021.
“We wanna make sure that that gap is filled. We have the ability to do it, we have the credentials to do it, and we’re doing it in a safe manner with collaboration,” Natson said.
“It’s gonna hurt the clients, it’s going to ultimately hurt the patients,” Natson said. “It’s not about us, it’s about patients.”
Story said the practitioners are encouraging unity.
“We’re actually encouraging unity. We’re not separate, we’re together. Whether you’re a FNP, whether you’re a psych mental health nurse practitioner, does not matter what type of nurse practitioner you are, we are one, and our goal is to make sure we provide the best care possible to our patients,” Story said.
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