Coalition Battles AMA Campaign to ‘Thwart’ Other Disciplines’ Scope Expansion

ImageThe 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:

protect patient safety and ensure the highest level of (name your type
of MD care), (our MD association) is engaged in an ongoing battle
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.”


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
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

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

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.

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Written by John Weeks

Explore Wellness in 2021