Rose Okoro, a nurse practitioner who specializes in family medicine, opened the Daystar Family Clinic in Katy, Texas, last October. Seven months later, she has only enough patients to work there part time. It is not because of demand but because of a law that ties the work of nurse practitioners to doctors, said Okoro, who has a doctorate in nursing practice. State regulations do not allow her to be reimbursed by insurance companies unless the physician who supervises her has a contract with those companies. Nurse practitioners in Texas have long fought against state regulations that link them financially and professionally to supervising physicians, a construct they say ties their hands and limits their ability to treat patients.