Milwaukee Journal Sentinel: Wisconsin’s nurses just got more freedom — and patients win
If you’ve ever been stuck in a waiting room, staring at a clock and counting the ceiling tiles, you know how frustrating it can be to see a doctor.
Wisconsin’s healthcare system has long been grappling with this problem, and last month, the state took a bold step toward a solution. Lawmakers quietly but meaningfully expanded the scope of practice for certain nurses, allowing advanced practice registered nurses (APRNs), such as nurse practitioners (NPs) and certified nurse-midwives (CNMs), to work independently, without the need for a supervising physician.
What does this mean in plain language? For decades, NPs and CNMs — highly trained healthcare professionals who often serve as the first line of care — were tethered to doctors by “collaborative practice agreements.” Essentially, these nurses could only do the full extent of their training if a doctor signed off on it.
But Wisconsin’s new law lifts that tether. Now, these nurses can evaluate patients, diagnose conditions, prescribe medications, and even manage chronic diseases on their own. Think of it as giving these nurses the keys to the clinic they’ve been running in all but name.
This is more than bureaucracy
At first glance, this might seem like a small bureaucratic tweak. But the ripple effects are anything but small. According to research from the Pacific Legal Foundation, states that remove or loosen these restrictive agreements see tangible benefits for both patients and the healthcare system at large.
First and foremost: access. Patients in rural and underserved areas, where doctors are scarce, gain more options and shorter wait times. NPs and CNMs, once constrained by unnecessary regulations, can finally practice to the full extent of their training. Such restrictions were less about patient safety and more about professional turf wars.
In a state like Wisconsin, where small towns can be hours away from a hospital, waiting for a doctor can literally be a barrier to care. Independent nurse practitioners can fill those gaps, providing everything from routine checkups to management of chronic conditions like diabetes or hypertension. Studies suggest that patient outcomes under nurse-led care are comparable to — or in some cases better than — physician-led care. Fewer bottlenecks, faster care, and patients who don’t have to choose between driving two hours or delaying treatment: that’s a clear win.
Wisconsin patients can get faster care
The benefits of allowing nurses more freedom to practice independently are well-documented. A 2017 study finds that patients in states with independent nurse practitioners (NPs) reported more convenient appointment scheduling, reduced travel times, and increased access to a consistent care provider. The same study estimates that the increased availability of NPs in medically underserved communities would result in a 30 percent increase in access to primary care services.
In addition, walk-in clinics offering non-emergency care, known as retail clinics, are often staffed by NPs and are often less expensive than visits to emergency rooms or hospitals. A 2013 study found even lower costs for visits to retail clinics staffed by NPs in states in which NPs had independent practice authority. The study estimates $1.8 billion in cost savings through retail clinic visits and an additional $810 million in savings if all states were to allow for independent NP practice.
Skeptics might worry that expanding nurses’ autonomy risks patient safety. But evidence across the country suggests otherwise. Under the new Wisconsin law, an independent license will only be granted to NPs who have conducted 3,840 hours of professional nursing in a clinical setting over at least two years. These are experienced nurses.
That is why states that have already allowed independent practice for APRNs have seen comparable levels of care to that offered by physicians. The areas allowing nursing independence often see improved adherence to treatment plans, higher patient satisfaction, and more timely interventions for chronic conditions.
Independent practice can also bring about economic efficiency. Healthcare costs are skyrocketing, and every bottleneck adds to the strain. Allowing NPs and CNMs to operate independently can reduce the burden on emergency rooms and specialist clinics. When patients can get primary care or maternal check-ups closer to home and sooner, they are less likely to develop complications that require expensive interventions. It’s good for patients, good for insurers, and — crucially — good for the overall resilience of Wisconsin’s healthcare system.
The benefits are clear when APRNs are liberated to practice, and patients are free to choose their providers. Pacific Legal Foundation recognizes this truth and is helping these skilled providers fight these unnecessary restrictions. By removing red tape for APRNs to practice independently, Wisconsin is signaling that it values efficiency, evidence, and freedom over a mere check-in-the-box by physicians.
For patients, it’s a meaningful shift: fewer waiting rooms and faster care. For providers, it means fewer bureaucratic formalities that are divorced from competency and safety. And it will certainly save us all a great deal of time.
This op-ed was originally published in the Milwaukee Journal Sentinel on September 24, 2025.
