Trending
"The next available appointment with the cardiologist is in three months." For many people living in rural Pennsylvania, healthcare access is a waiting game. Obtaining access to timely medical care may entail traveling long distances, taking time off work, or waiting months for an appointment. For those who have chronic conditions, these delays make it difficult to receive the care they need.
Pennsylvania struggles with a serious healthcare provider shortage. The Pennsylvania Department of Health (2025) concluded that rural communities have approximately one primary care physician for every 522 residents in comparison to 222 residents in urban communities. In addition to this, the Center for Rural Pennsylvania (2025) reported that approximately 54% of rural residents live in medically underserved areas.
As a registered nurse preparing to practice as an adult gerontology primary care nurse practitioner, I feel there's a gap in the care we are able to provide. I believe as advanced practice providers, Pennsylvania policymakers can make better use of its existing healthcare workforce. Senate Bill 25 offers an opportunity to address some of these barriers. This bill would remove collaborative agreements for nurse practitioners after completing three years of collaborative practice (Pennsylvania General Assembly, 2025). Essentially, the NP would have undergone full time training with a licensed physician before being able to provide care independently.
Nurse practitioners are nurses with advanced training capable of diagnosing illnesses, prescribing medications, and managing chronic conditions. They work alongside physicians in primary care offices, inpatient settings, and specialty practices. However, Pennsylvania requires nurse practitioners to maintain formal collaborative agreements with physicians. While collaboration is important to patient care, these agreements may hinder timely care in communities already experiencing physician shortages.
For rural and underserved communities, this means experienced nurse practitioners can actually
establish their own primary care practices and provide routine services for people who currently
have to travel hours to see a healthcare provider. Furthermore, the benefits extend beyond primary care. Nurse practitioners also work in specialties such as gynecology, cardiology, and oncology. Although they cannot substitute specialty physicians, they can help manage chronic conditions, provide follow up care, and treat diseases within their training and expertise.
Critics of Senate Bill 25 highlight that physicians undergo more extensive and intensive hours of medical training than nurse practitioners, raising questions about patient safety when complicated medical cases arise. These are all valid points, but passing Senate Bill 25 does not mean nurse practitioners will practice outside of their training/education scope. The purpose of this bill is to assess knowledge gaps and training limitations so that nurse practitioners can develop clinical competence in order to provide the best care for their communities. Others proponents of maintaining reduced practice for NPs argue that expanding practice authority will not necessarily attract more advanced practice nurses to rural areas. This is true. However, changing practice authority alone isn't a "fix all" solution. It cannot resolve issues involving hospital closures, lack of insurance, transportation barriers, or workforce recruitment. To actually solve these systemic issues, Pennsylvania needs to broaden investments in rural healthcare facilities and incentives for healthcare providers to serve neglected populations. With this being said, reducing administrative obstacles for nurse practitioners is an important part of the solution.
Rural Pennsylvanians deserve reliable health care and they need it now. They cannot afford to
keep waiting and hoping that appointment slots will open suddenly. I strongly urge readers to
reach out to their state senator and ask them to vote yes on Senate Bill 25. It is a crucial step
toward closing the healthcare gap in our most underserved counties.
ALFRED CHAN
Philadelphia
Submitted by Virtual Newsroom