AMA Scope of Practice Partnership Targets 30 Legislative Efforts of DCs, NDs, LAcs and CPMs in 2009
Written by John Weeks
AMA's Scope of Practice Partnership Targets 30 Legislative Efforts of DCs, NDs, LAcs and Certified Professional Midwives in 2009
Summary: The American Medical Association has been working in opposition to over 30 state legislative actions of naturopathic physicians, chiropractors, acupuncture and Oriental medicine practitioners and Certified Professional Midwives in 2009. The list of these actions, published here, is part of a broader list of 154 against all non-MD profession which the AMA as part of that guild's Scope of Practice Partnership campaign (AMA SOPP). The campaign, begun in 2006, is presented by the AMA as a public safety concern, though little evidence has materialized suggesting that this is other than an effort to keep other professions from entering the MDs turf. Here is the complete list of 30, and a link to the broader list of 154.
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A campaign against other disciplines
The American Medical Association's Scope of Practice Partnership
(AMA SOPP) campaign, through which the AMA has been
monitoring and typically fighting against scope expansions by non MDs since 2006
has its hands full. A chart from the AMA available here
lists 154 separate legislative campaigns in various states in 2009 which it opposes. These are from
professions ranging from psychologists, advance practice nurses and
optometrists to naturopathic doctors and chiropractors and other
nominally "CAM" disciplines. Below is the subset of actions related to complementary and alternative healthcare practices which made the AMA's watch list.
_______________________________
CAM Field State Legislative Action on the Watch-List
of the AMA's Scope of Practice Partnership Campaign
ND = Naturopathic doctor
DC = Doctor of Chiropractic LAc = acupuncture and Oriental medicine practitioner
CPM = Certified professional midwife
State
Profession
Scope of Practice Issue
(in the terms used by the AMA*)
California
NDs
Prescribing privileges
Colorado
DCs
Ability to refer to selves
as "physicians"
Colorado
NDs
Licensure
Delaware
CPMs
Licensure
Idaho
CPMs
Licensure
Illinois
NDs
Licensure
Indiana
CPMs
Licensure
Michigan
DCs
Authority to determine differential
diagnosis; access to imagine (sic)
technology
Michigan
DCs
Authority to treat the entire body,
including joints and extremities
not currently permitted
Missouri
CPMs
Licensure
Missouri
NDs
Licensure
New Hampshire
NDs
Prescribing privileges
New Mexico
LAc
Expanded prescriptive authority
New York
DCs
Scope of practice expansions within
workers’ compensation
New York
NDs
Licensure
North Carolina
DCs
General scope expansions
North Carolina
CPMs
Licensure
North Carolina
NDs
Licensure
Ohio
NDs
Licensure
Oklahoma
NDs
Licensure
Oregon
DCs
General scope expansions
Oregon
NDs
Prescribing privileges
South Carolina
DCs
General scope expansion
South Carolina
NDs
Licensure
Tennessee
NDs
Licensure
Texas
LAc
Licensure
Utah
CPM
General scope expansions
Virginia
NDs
Licensure
Wisconsin
DCs
General Scope expansions
Wisconsin
NDs
Licensure
Also
Nevada
"Alternative Medicine
Practitioners/CAM"
General scope of practice expansions
without registration/regulation/
licensure
Various states
"Non-
physician
providers"
An array of issues including: ability
to employ MDs; use of lasers;
administration of certain injectable
materials including, but not limited
to, flourescein dye, collagen or
Botulinium toxin
(*) In some cases prescribing rights already exist and the issue is
expansion of those rights.
Of the 154 areas of concern to the AMA, 30 (19%) relate directly to the
distinctly licensed, or would-be-licensed, complementary and
alternative healthcare fields. Of these, 14 were legislative initiatives of
naturopathic doctors, 8 of chiropractors, 6 those of certified professional midwives (homebirth-oriented direct-entry midwives) and 2 involving practitioners of acupuncture and Oriental medicine.
The mother of all coalitions: 35 organizations, led by nurses, and including DCs, NDs, LAcs and others
The AMA-SOPP campaign, initiated in 2006, stimulated the formation of the Coalition for Patients Rights, led by advanced practice nurses. (See initial Integrator article on the campaign, Coalition Battles AMA Campaign to "Thwart" Other Disciplines' Scope Expansion, June 21, 2009.) The
American Chiropractic Association, American Association of Naturopathic
Physicians, American Association for Acupuncture and Oriental Medicine
and the Integrated Healthcare Policy Consortium
are among the 35 organizational members of the Coalition. The most
recent Coalition action noted on their website was a May 29, 2009 letter to President Barack Obama which argued that "the more than
three million healthcare professionals in the U.S. who are not
doctors of medicine or osteopathy are critical stakeholders in the
movement to improve our nation’s healthcare." The letter, available here made the case for greater inclusion of these professions.
Comment: The AMA has
never shown any real threat to the public from the practitioners they
are seeking to restrict. Conversly, if there is a real threat on one or more, one is not likely to recognize it because the AMA has surrounded it with campaigns that are clearly against the public's interest and wishes. Ahh, to be guided instead by the rational approach that the Pew Foundation laid out during its decade of exceptional work against how guild interests block quality healthcare reform. The combination of the significant financial
benefits from being an MD (see "Factoids to ponder: Salaries of conventional physicians in 2007, from JAMA," in
the August 6 - September 3, 2009 Integrator Round-up) and these campaigns cast the MD guild in an ugly light
in which the concept of a service industry is thoroughly transformed
into one meant for self-service. One recalls that Exxon's lawyers are also part of a service industry.
Note: For a list of 6 prior Integrator articles on the AMA-SOPP, click here and scan down.
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