Over the past decade, every legislative session has involved scope of practice conflicts between organized medicine and allied health practitioners. In each, medicine successfully fended off nonphysicians' attempts to practice medicine, or developed collaborative agreements to improve patient care while assuring physicians continue to lead the medical team.
Despite that successful history, scores of allied health care
professionals began the 79th legislature confident that the time
had finally arrived for them to expand their legal scope of
practice. Optometrists were after authority to manage glaucoma and
perform surgery. Podiatrists wanted to operate above the foot.
Other allied health providers also thought the time was right to
win more clinical independence.
Many of these practitioners had contributed freely to newly
elected legislators. They lined up bill sponsors. And they knew
that this session would provide a host of must-pass bills onto
which they could tack scope-expanding amendments. The Texas State
Board of Medical Examiners and nearly all of the allied health
regulatory boards were up for sunset review - the
once-every-12-years government housecleaning in which an agency
must be re-created by legislation, or die.
TMA and 11 other medical and specialty societies coalesced into
PatientsFIRST, dedicated to protecting public safety. Coalition
members collaborated to oppose any attempt to expand allied health
practitioners' scope of practice beyond what their education,
skills, and training safely allow.
In April, only the optometry and podiatry challenges were still
moving. Physicians of all specialties collaborated to make sure
they didn't move far. Patient safety issues dominated the debate,
with organized medicine roundly demonstrating that only physicians
have the clinical expertise and training to perform services sought
by allied health groups. The sponsors of the sunset bills -
especially Sen. Jane Nelson (R-Lewisville) and Rep. Burt Solomons
(R-Carrollton) - kept their promises to keep those bills "clean."
In the end, organized medicine triumphed. The 79th legislative
session ended without one single expansion of a nonphysicians'
scope of practice.
Scope of Practice TMA Staff Contacts:
- Yvonne Barton, Legislative Affairs, (512) 370-1359
- C.J. Francisco, JD, Office of the General Counsel, (512)
Inadequate Health Plan Networks
Managed Care/Insurance Reform
Texas State Board of Medical
Examiners Sunset and Physician Licensure
Agency Sunset Review
Corporate Practice of Medicine
Health Care Funding
Medicaid and CHIP
Indigent Care and the
Professional Liability Reform
Child Health, Safety, and
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