Across the nation, the fight’s on to protect physician-led care

Across the nation, the fight’s on to protect physician-led care

The AMA helped defeat over 100 scope-creep bills in 2023. Learn about this year’s ongoing battles to stop proposals that threaten patient safety.


By Kevin B. O'Reilly , Senior News Editor


After helping state medical associations and national specialty societies defeat more than 100 bills to inappropriately expand nonphysicians’ scope of practice in 2023, the AMA is again relentlessly joining its allies in organized medicine to continue the fight for physician-led, team-based care in this year’s legislative session.

This intensive and effective advocacy effort has ranged across the country, as the AMA has helped battle scope creep in Alaska, Connecticut, Georgia, Oklahoma, New Hampshire and elsewhere.

Fighting scope creep is a critical component of the AMA Recovery Plan for America’s Physicians.

Patients deserve care led by physicians—the most highly educated, trained and skilled health professionals. The AMA vigorously defends the practice of medicine against scope of practice expansions that threaten patient safety.

This year, multiple bills have been introduced across the country to expand the scope of practice of naturopaths by authorizing them to prescribe medications. The AMA is staunchly opposed to these proposals.

With no residency training requirement, naturopaths lack the robust clinical training of a physician. Notably, there is no guarantee that a naturopath will encounter a broad range of illnesses or conditions in the patients they treat during their clinical education. A naturopath’s pharmacological education is combined with, and taught alongside, naturopathic therapeutics and philosophies such as botanical medicine and homeopathy. That education, simply put, is not comparable to that of a physician.

When all is said and done, the AMA believes that naturopaths lack the education and training necessary to safely diagnose and prescribe medications to patients. And yet bills proposed across the country would allow naturopaths to do just that, and with very few guardrails.

AMA Trustee Scott Ferguson, MD, has taken these bills to task. He has testified against naturopath prescribing bills in state legislative hearings in Connecticut and Alaska. Before state legislatures, Dr. Ferguson—as a physician expert and former legislator himself—has effectively compared the educational preparation of a naturopath to that of a physician and championed the importance of the medical education and residency training in providing medical care to patients. Representing the AMA, he has advocated strongly against these proposed scope of practice expansions.

The legislatures in Alaska and Connecticut have yet to make final decisions on these naturopath scope of practice expansion bills. Naturopath scope expansion bills have failed in Washington and Florida this session.

Learn more with Dr. Ferguson about what doctors wish patients knew about scope of practice.

CRNA scope expansion legislation

The Medical Association of Georgia successfully defeated several scope of practice bills during the 2024 legislative session that adjourned last month. At the top of this list are two measures—Senate Bills 419 and 460—that would have removed language requiring anesthesia services provided by certified registered nurse anesthetists (CRNAs) to be done under the direction and responsibility of a physician.

Defeating these bills preserves physician supervision of nurse anesthetists, which is imperative to protect the safety of patients receiving anesthesia. A grant from the AMA Scope of Practice Partnership helped support the state medical society’s advocacy efforts.

Check out the full article to learn more about multiple scope-creep bills introduced across the country, and the intensive advocacy effort to defeat them.


Advocacy Progress Report

The AMA is advocating for you and achieved wins in 5 critical areas for physicians. Catch up in our Advocacy Progress Report.

But we can't do this without you. Become a member and help the AMA defend against scope of practice expansions that threaten patient safety.

Join the AMA today.

Jessica Bixby

Freelancer at Freelance

3mo

Care has been led/limited by Insurance, Medicare, medicaid and non medical administration. Both Doctors and patients must navigate obstacles to give/receive proper care.

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Md Aminur Islam

I am professional Graphics Desiger

3mo

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Meara M.

CPC-A looking to enter the medical coding field

3mo

As someone who has nearly been a “professional patient” now getting into healthcare through the revenue cycle, the only validity I see in this article is the movement towards naturopaths as physicians considered being potentially a bad trend. We have a doctor shortage while simultaneously patients feel unheard, unseen, and condescended to. Not only do we need well-educated physicians, there needs to be a breaking of the “fourth wall” between the provider and the patient. That may sound like more pressure on the medical provider, but there could be entire fields of work surrounding this issue that could be defined to help providers and make LESS work for them. Most people seek naturopaths after disillusionment with modern medicine. They may have been dismissed and are desperately trying to find someone to listen to them. So, they look beyond medical physicians to someone who will make the patient feel heard.

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Jacquelyn Bolden

Doctor of Philosophy - PhD at Boston University Graduate School of Arts & Sciences

3mo

Lucy Marshall I should add that, while you're entitled to your world view, I am entitled to mine. I have had the privilege of engaging people who were patients who expressed confusion about the credentials and training of health professionals assigned to treat them. I designed and conducted focus groups last year. DlThey were commissioned to identify the impact of "creep". Health related fields have expanded significantly since the mid 20th century. There were none of the professions in existence in 1960. PAs began to be credentialed in the 70s. Space for these new professionals to evolve happens when an EXISTING medical professions needs to expand/contact some dimensions of their pracice. Increasing specialization among physicians, for example, changed family practitioners' roles/responsibilities. My first profession of Occupational Therapy emerged from nursing and social work

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So what is the plan in Massachusetts for the projected loss of primary care MDs leading to not enough doctors to care for people? There is already a crisis here, so much so that legislators are now trying to develop a plan. An overwhelming number of people can not see an MD as PCP because they “are not excepting new patients “. Hence, Massachusetts now allows NPs independent practice. There are literally over 300 million people in the United States , I truly believe there is enough work to go around. I laugh, “every patient deserves physician led care” , be nice if they accepted new pts and were actually available to them.. this timeless argument is moot. AMA should be more concerned with serious healthcare issues and policies. Trying to minimize and demean another profession is unbecoming.

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