Ann A. Lewis, FNP-C Owner and FNP Provider Sampson Medical Services, P.A, Surf City, NC

What are your privileges and prescriptive authority?

Ann Lewis does not want hospital privileges. She has a practice based on 4000 patients and does not want hospital duties in addition to primary care duties. She refers patients needing hospitalization to her “supervising” physician, Timothy T. Smith DO. He was a Physician Assistant who went back to school and has opened his own practice in the Clinton, NC area. She knew him as a so-called “renegade” and approached him to be her supervising physician (as required in North Carolina). “He was a P.A. before becoming a physician and knows what I’m up against in private practice.”

Ann’s prescriptive authority is not limited at this time; however, until 1999 NPs could not procure narcotics and this was problematic for solo NP practices. Until 1999, NPs in North Carolina could order, dispense, and administer narcotics with their DEA numbers but could not procure the medications. Ann Lewis wrote the legislation necessary to enact a change in this situation. She went through the NC Board of Medical Examiners to achieve her goal. She is a storyteller – a pretty good one – and her examples of patients with renal colic were meaningful to physicians and legislators.