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Coalition Battles AMA Campaign to "Thwart" Other Disciplines' Scope Expansion PDF Print E-mail
Written by John Weeks   
Wednesday, 21 June 2006

ImageCoalition Battles AMA Campaign to "Thwart" Other Disciplines' Scope Expansions

The Scope of Practice Partnership (SOPP) of the American Medical Association, organized to "thwart" scope of practice increases of other disciplines, is being met be a strong, multi-disciplinary coalition.

The AMA
claims that the interest of their "partnership" is in protecting the public from under-trained practitioners. (See related IBN&R article on the AMA campaign.) To use the words off an American Academy of Ophthamology website on the SOPP:
"To protect patient safety and ensure the highest level of (name your type of MD care), (our MD association) is engaged in an ongoing battle against non-physicians who do not have the education or training to diagnose or perform (name your MD organization's practices here)."

One close observer of the new coalition to oppose SOPP, who wished not to be named, captured the rallying energy succinctly: "It's preposterous for a profession that is admittedly already killing over 100,000 people a year to come after other professions on the issue of safety."

Image
Carol Bickford, PhD, RN, ANA point person
Nursing Groups Take the Lead


The coalition has been galvanized by the American Nurses Association and a network of nursing specialty organizations. Almong the other organizations involved in the first phase are the American Chiropractic Association, the Americal Psychological Association and the American Physical Therapy Association. These organizations,
representing over 3-million licensed practitioners, have come together as the Coalition for Patient Rights (CPR). Numerous other organizations have either announced an interest in joining the coalition.

Life the AMA, the Coalition frames its case based on patient interests: "In the face of organized medicine’s latest divisive efforts to limit these professionals’ abilities to provide the care they are qualified to give, the CPR was formed for the sake of patients—to ensure that the growing needs of the American health system can be met and that patients everywhere have access to quality health care providers of their choice."

Specific objectives include overturning Resolution 814 from the November 2005 AMA House of Delegates, entitled
“Limited Licensure Health Care Provider Training and Certification Standards.” The AMA resolution states:
"Resolved, That our American Medical Association, along with the Scope of Practice Pasrtnership and interested Federation partners, study the qualifications, education, academic requirements, licensure, certification, independent governance, ethical standards, disciplinary processes, and peer review of the limited licensure health care providers, and limited independent practitioners, as identified by the Scope of Practice Partnership ... "
Coalition Members Agree to Joint Statement

The joint statement of the Coalition members focuses attention on the following areas:

  • States that studies have shown that care of practitioners represented by the coalition "is safe and of high quality."
  • Argues that "now is the time to encourage the increased use of all available health care professionals to meet the growing demand for affordable, high quality care."
  • Asserts that MD organizations cannot be presumed to be objective or balanced in their assessment of education and training of other practitioners.
 
The AMA has
stepped in it
this time.

 The resolution

of the Coalition,
while a
reasoned
call to
cooperation,
is
clearly, also,
a call to arms.



  • Suggests that "a balanced study should include an evaluation of whether physician scope is overbroad."
  • Challenges AMA claims that non-MD practitioners cannot be significant factors in meeting the needs of the underserved.
  • Takes on AMA's terminology which subordinates allied health as "non-physician" or "limited licensure" providers, asserting that Coalition members are "not adjuncts and can be independently responsible" for care.
  • Requests that AMA cease its "divisive" campaign and work cooperatively to meet healthcare challenges.

The Coalition is open to other members. IBN&R has learned that some CAM disicplines, beyond chiropractic, are exploring joining.


Comment:
The AMA has stepped in it this time. The joint resolution by the Coalition members, while a reasoned call to cooperation, is clearly, also, a call to arms. One senses, in the resolution, the sword is half out of the sheath. While not referenced, medical deaths linked primarily to MD practice will haunt this AMA "safety" campaign.

The gloves are off. Note the profound challenges to the god-position of the wide-open scope
granted to medical doctors, regardless of their training:
"A balanced study of health care professions would include an evaluation of physician scope of practice and consider whether physician scope of practice is overbroad. Such a study would also assess whether state laws and regulations governing physician practice contain outdated language that should be eliminated so that the unique skills of licensed health care professionals who do not hold a medical license are recognized. The study would also evaluate the implications of current state laws that allow physicians to practice in any specialty, regardless of individual qualifications to do so."

This is a second, significant coalition to be formed in recent months by these and other professional organizations. They are united in their need to have fought for a place against AMA control. This effort is about protecting scope. The earlier, a successful opposition to a piece of federal legislation, S 1955, was about protecting insurance coverage. (See related IBN&R article.) 

From a Common Enemy to a Common Platform?


This coalition and
that to protect
insurance coverage
were formed around
common enemies.

Is there ground here
for the beginning of
a pro-active health
reform coalition? 

Notably, both this scope coalition, and the earlier insurance coalition, formed around a common enemy. (In both, directly or indirectly, the AMA's turfism is the active or masked enemy.)

But is there ground here for the beginning of a common platform? 

I have personally been waiting, particularly with the nursing shortage, for the nurses to stand up and take more power in healthcare policy and practice. Has this sleeping giant awakened? And what better way to announce a new way of doing healthcare business than to walk into the halls of Congress, not alone, but arm in arm with psychologists, physical therapists, chiropractors, and a dozen other CAM and other disciplines?

There is a lot on which these disciplines could agree. About healing. About increasing human touch and time. About wholism. About taming medicine's disastrous technology affliction. And about diminishing the economic, practice and policy clout of the surgical specialists who run medicine.

My bet is that not a few of the AMA's poorer cousins would rather take to the vision of healthcare priorities that these Coalition professions, representing perhaps 4 million strong, would articulate.
These are the least paid and closest to the people of the specialties, in the pediatrics and family practice, as well as the emerging "specialty" of integrative medicine.

One can almost picture a force, with a little tweaking, which could actually transform health care. Imagine that!

Meantime,
it will be interesting to see whether associations representing naturopathic physicians, AOM practitioners and other CAM providers will apply to join, and be welcome in, this Coalition.
Last Updated ( Wednesday, 21 June 2006 )
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