HARRISBURG -- Nurse practitioners soon could play a bigger role in health care in Pennsylvania.

Gov. Ed Rendell wants to revamp healthcare in Pennsylvania, starting with a change in regulations that restrict treatment by nurse practitioners, who charge less than physicians.

Mr. Rendell expects to unveil a plan in January, but he provided a glimpse yesterday during his traditional year-end news conference.

"The test for us is, are we going to have the intestinal fortitude to look down the barrel of special interests and say, 'Uh-uh guys, not this time. Health care is too important of an issue," Mr. Rendell said.

"I want to free nurse practitioners to do anything they are capable of doing," Mr. Rendell said.

Nurse practitioners are registered nurses who have master's degrees and at least 500 hours of clinical training. In Pennsylvania, they are allowed to evaluate patients, prescribe most medications and provide certain treatments.

Mr. Rendell wants them to do more.

"Nurses can't even do stitches in Pennsylvania except in the presence of a doctor," he said. " There are a thousand other examples like that."

Pennsylvania is "one of the most backward states when it comes to what we allow nurse practitioners to do," he said.

Kathy Magdic, program coordinator for the acute care nurse practitioners at the University of Pittsburgh, agrees that change is needed in outdated regulations that were written before nurse practitioners were common.

One regulation, for example, prevents nurse practitioners from giving employment physicals to teachers, although they are allowed to give physicals generally, she said. They also are prohibited from evaluating disabled people who need physicals as a condition of receiving welfare benefits.

"Little things like that provide barriers," said Ms. Mogdic, who also is an executive board member of the Pennsylvania Coalition of Nurse Practitioners.

"If nurse practitioners could practice to the fullest extent of their educational preparation, that would certainly allow patients more access to health care," she said.

The issue isn't clear-cut, said Chuck Moran, director of media relations for the Pennsylvania Medical Society, which represents 19,000 doctors and medical students.

The society would like the nurse practitioners' role to stay the same.

"Everybody is concerned about the rising costs of health care and the nurse practitioners say they can do it a little bit cheaper but, with the way it's set up now, there is a patient safety net," he said. "Patients really like nurse practitioners but they like the safety net of a physician."