Relating to an education program to enable certain students to practice medicine in certain rural counties and to physician delegation of certain medical acts to advanced practice registered nurses, including in certain rural counties.

89th Legislature (2025) Introduced by Greg Bonnen and 2 co-sponsors

Texas bill expands medical student practice and APRN authority in rural counties to address physician shortages, trading increased access against traditional oversight requirements.

Placed on General State Calendar

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Legislative bill overview

SB 2695 creates an education program allowing certain medical students to practice medicine in designated rural Texas counties and expands the scope of practice for Advanced Practice Registered Nurses (APRNs) to perform medical acts under physician delegation, particularly in rural areas. The bill aims to address healthcare workforce shortages in underserved regions by enabling earlier clinical practice and broader APRN autonomy in rural settings.

Why is this important

Rural Texas counties face significant physician shortages, leading to reduced access to primary care and emergency services. By allowing students and APRNs to expand their roles in these areas, the bill could increase healthcare availability in medically underserved communities. However, this approach trades off traditional supervision requirements against the practical need for care access.

Potential points of contention

Patient safety concerns: Permitting medical students to practice independently (even in limited rural settings) before full licensure raises questions about oversight and liability, particularly for complex cases

APRN scope expansion: Broadening APRN authority to perform medical acts without clear limitations on which acts qualify could create inconsistency in care standards and licensing protections

Urban physician impact: Rural practice incentives may be perceived as disadvantaging urban areas or creating two-tiered healthcare quality standards

Delegation accountability: Ambiguity around physician responsibility when APRNs perform delegated medical acts in remote settings where direct supervision may be limited