Nurse practitioners say Missouri’s physician oversight rules are blocking access to patient care

Nurse practitioners and midwives have been pushing to get the law changed in Missouri, but haven’t made any progress. Now, one Columbia nurse is suing the state.

In 2020, Marcy Markes was confronted with a harsh reality.

A nurse practitioner who has specialized in allergy and asthma care for more than two decades, she was forced to close three of her rural allergy clinics in central Missouri and consolidate her practice at her clinic in Columbia.

Why? Missouri is one of 11 states that require advanced practice nurses such as Markes to have oversight from a physician.

The rules on how nurse practitioners can see patients in Missouri are meticulous. Nurse practitioners must be within 75 miles of the physician who oversees them on a daily basis, and physicians must sign off on the nurse’s