Historically, Illinois has been one of the most conservative states for all non-physician providers. With antiquated policies coming to an end, NPs and PTs will finally be able to practice to their fullest extent. With the political landscape of Illinois changing, physical therapists (PT) will have direct access and nurse practitioners (NP) will be able to practice independently. While this is a huge celebration for both professions, there are caveats. According to HB4643, a PT may evaluate and treat a patient for 10 visits (or 15 business days, whichever comes first) without a written prescription from a provider. Thereafter, the PT must notify the patient’s healthcare provider within 5 business days of starting treatment. Under HB313, NPs will be able to practice independently after obtaining 4000 hours of clinical experience with a provider and 250 hours of continuing education.
PTs not having direct access in Illinois is pretty archaic, as there are many states that have direct access and it does not compromise patient safety. Massage therapists and personal trainers continue to see patients without a script despite PTs having doctoral level training. Does it make sense that they have full autonomy with their clients but PTs do not? Not really. At last, physicians do not have to waste their time seeing a patient they would normally refer to PT anyway. Patients not appropriate for PT can be screened by the therapist and referred to the physician. This new policy does not undermine the collaborative relationship of the PT and provider: it actually strengthens it.
NPs will be able to provide primary care without collaborative written agreements after ~2 years. Collaboration will continue to exist, but there will be substantially less paperwork for physicians. Why should NPs be restricted by written agreements when other states have proven that independent NPs can provide safe and effective care? An NP will never be able to replace a physician who has completed residency and/or fellowship. However, NPs are vital, as they have shown that they are safe and cost-effective with their care.
I never thought I would see these rules change in my lifetime. With greater power comes greater responsibility; nevertheless, both of these professions are equipped for the challenge. More information can be found at the following websites: