Practice agreements for PMHNPs in Michigan

Practice agreements for PMHNPs in Michigan

PMHNPs in Michigan offer delegated patient care under direction the supervision of a physician and in accordance with a written agreement.   According to Hansen-Turton et al (2015), delegation agreements must be in writing, particularly if the nurse practitioner is to prescribe schedule II to V controlled substances. A written agreement must contain the license number and name of the nurse practitioner and physician, along with the date when the agreement was written, and any exceptions or limitations to the agreement and delegation should be appraised and updated yearly. Practice agreements for PMHNPs in Michigan


Two Physician collaboration issues

The requirement for collaboration with a physician prevents PMHNs from practicing to the fullest level of their training and education and also acts as a serious impediment to accessible care, particularly in rural populations. Holfer et al (2018) assert that for decades, rural areas have been affected by the shortage of providers.  PMHNPs are assisting to lessen this shortage. Nevertheless, scope of practice laws prevents them from offering care to different populations in a range of settings.

Barriers to PMHNPs practicing independently in Michigan

State scope of practice laws and lack of recognition of PMHNPs as primary care providers are barriers to PMHNPs practicing independently in Michigan. Physician groups believe that nurse practitioners lack sufficient training and thus are not capable of offering safe and quality care like that provided by physicians.  As DeCapua(2019)claims, despite the vast proof that nurse practitioners offer resource, efficient, affordable care with superior outcomes,  Michigan state operates under  restricted practice, which limits the capability of nurse practitioners to work independently in accord with their degree of education and training. Practice agreements for PMHNPs in Michigan

How I might address PMHNP practice issues in Michigan

I might address PMHNP practice issues in Michigan by actively campaigning for relaxation of scope of practice regulations to allow PMHNPs to practice autonomously with the requirement for a delegation agreement. I would also call for physician groups to understand that PMHNPs are not competing with physicians but are part of the healthcare team and they need to work together to improve patients’ health. I would convene physician and nurse organizations to develop an agreement on interprofessional collaboration and its benefits to the patient.


DeCapua, M. (2019). How Does Nurse Practitioner Authority Vary By State? Retrieved on April 30, 2019 from

Hansen-Turton, T., Sherman, S., & King, E. (2015). Nurse-Led Health Clinics: Operations, Policy, and Opportunities. New York: Springer Publishing Company.

Holfer, R., Ortiz, J., & Bushy, A et al. (2018). Impact of Nurse Practitioner Practice Regulations on Rural Population Health Outcomes. Healthcare (Basel), 6(2): 65. Practice agreements for PMHNPs in Michigan


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