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Physician Group Urges Lawmakers to Remove Outdated Regulations on APRNs, Joins Statewide Coalition

Texas Doctors for Social Responsibility joins Texans for Healthcare Access

AUSTIN – Texans for Healthcare Access – a diverse coalition of organizations representing consumers, businesses and healthcare stakeholders – today announced that Texas Doctors for Social Responsibility has joined the coalition in its efforts to repeal outdated, unnecessary regulations that are preventing Advanced Practice Registered Nurses (APRNs) from providing more access and more options to Texas patients.

“As medical professionals, our members understand the dire need to expand health care access in Texas and that it should be done together, not in competition, with advanced practice nurses,” said Dr. Jaime Estrada, President of Texas Doctors for Social Responsibility. “Everyone wants a healthier Texas, and casting off cumbersome and unnecessary regulations on APRNs is a much-needed step in the right direction.”

The timing of this announcement is especially important as Texas continues to address the COVID-19 crisis and our state’s growing population.

“It is more important than ever to support common sense policies that will put patients first,” said Christy Blanco, President of Texas Nurse Practitioners. “If we are to see this crisis through and meet the needs of our state’s growing population then we need everyone – physicians, APRNs, and all of our state’s health care providers. It is time to remove unnecessary barriers to care for the good of Texas patients.”

California and Florida, two of Texas’ biggest competitors for talent and business, are among 31 states who have done away with the requirement for APRNs to contract with physicians before they can practice. Advanced practice nursing is the only profession in Texas where independently licensed professionals are mandated to contract with a member of another profession in order to go into business.

A 2020 Texas Nurse Practitioner member survey found that more than 50% of nurse practitioners say delegation requirements prevented them from expanding or creating their own practice to care for more patients. Nearly 80% said they would consider practicing telehealth to patients outside of Texas in states that do not have such onerous regulations.

In 2013, Texas lawmakers removed the requirement that APRNs have an on-site supervising physician, yet years later the state continues to require them to have contracts with physicians before caring for patients. The law does not require APRNs and physicians to work together or to consult on any cases, mandating nothing more than a single phone call once a month. Further, in response to the COVID-19 crisis, Gov. Greg Abbott waived the delegation requirements temporarily, underscoring the fact these regulations are preventing APRNs from doing the most they can to provide care to the Texans who need it.

More than 7 million Texans live in primary care shortage areas. Studies have shown that APRNs tend to have a greater proportion of their practices in rural areas and other regions that are designated health professional shortage areas. In states that eliminate delegation agreements, APRNs have been 1.5 times more likely to practice in rural areas. Currently, more than 80% of nurse practitioners in Texas specialize in primary care.


Texas Doctors for Social Responsibility is a tax-exempt 501(c)3 nonprofit organization. Its mission is to lead physicians and local communities as they advocate for a more just and cost-effective healthcare in the state of Texas.

Texans for Healthcare Access is a coalition of organizations representing consumers, business, and a broad range of healthcare stakeholders. These groups have joined forces to remove unnecessary barriers to care and allow Advanced Practice Registered Nurses to provide more access and more options for Texas patients. Learn more here.


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