Across the country, non-physician clinicians are working to expand their scope of practice to include the independent practice of medicine, without physician involvement.
The AOA, which opposes legislation that allows the independent practice of medicine by anyone who hasn’t completed state requirements for physician licensure, partners with state and specialty affiliates to fight inappropriate scope of practice expansion efforts at the state level.
“Access to health care continues to be a serious problem, but expanding the scope of practice of non-physician clinicians and unmatched medical graduates is not the solution,” says Raine Richards, JD, AOA director of state government affairs. “There is no substitute for the training, education and expertise of a fully licensed physician. All patients deserve to be able to see a fully licensed physician when seeking treatment. With patient safety in mind, better ways to improve access to care include expanding loan repayment programs for physicians and increasing residency funding tied to the provision of care in underserved areas.”
During the 2019 legislative session so far, the osteopathic medical profession celebrated several significant scope of practice wins.
1. Physician assistants in Hawaii
Hawaii’s HB935 would have allowed physician assistants to practice independently of physicians. The AOA and the Hawaii Association of Osteopathic Physicians and Surgeons advocated against the bill, which died upon the legislature’s adjournment in May.
2. Prescriptive authority for psychologists in Hawaii
Hawaii’s SB819 would have allowed psychologists with specific training to prescribe medication, including controlled substances, without physician supervision. The AOA and the Hawaii Association of Osteopathic Physicians and Surgeons advocated against the bill, which also died upon adjournment.
3. Advanced Practice Registered Nurses (APRNs) in Indiana
Indiana’s SB394 would have allowed APRNs who met certain criteria to practice independently after collaborating with a physician or another APRN for a specified period of time. The AOA and the Indiana Osteopathic Association launched a joint advocacy and grassroots campaign, which resulted in the bill’s defeat in April.
4. Unmatched medical school graduates in New Hampshire
New Hampshire’s HB509 would have allowed medical school graduates who did not match into a postgraduate medical training program to practice with limited supervision from a fully licensed physician. For the second year, advocacy from the AOA and the New Hampshire Osteopathic Association helped to defeat this concept.