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Affordable Care Act
Scope of Practice
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Scope of Practice
Promote Physician-Led Health Care Teams
Texas needs more physicians and other health care professionals working in all parts of the state, especially in rural and border Texas. But the real gains in improving access to and coordination of patient care will come largely from solidifying and expanding the use of physician-led teams. Team-based care capitalizes on the efficiencies of having the right professional providing the right services to the right patient at the right time … with overall direction and coordination in the hands of physicians.
Current Scope Issues
Texas Physicians Ask Lawmakers to Fund Critical Health Services
Seven of Texas’ largest physician organizations — representing more than 48,000 physicians and medical students — today urged state House and Senate budget negotiators to “craft a cost-effective budget that addresses Texas significant health care needs.”
TMB Should License Neurodiagnostic Technicians
Without question, the field of neurodiagnostic testing is growing, and neurodiagnostic technicians (NDTs) are becoming more important members of the medical care team in our continual efforts to improve patient care. We believe NDT licensure is important for the Texas Legislature to consider for the following reasons. First, the information NDTs provide helps guide diagnosis and the course of treatment physicians like me prescribe to our patients. Second, the neurodiagnostic testing that NDTs perform involves the insertion of highly specialized medical instruments into the human body. We believe the state of Texas has a public safety interest in understanding who these individuals are, and ensuring the training they receive is of the highest order and their technical skills comply with the highest safety standards.
Medicine's Bills Pick Up Speed
With roughly six weeks to go in the Texas Legislature, lawmakers near the finish line in drafting a state budget for the next two years with significant improvements over last session that march the house of medicine closer to accomplishing its goals. With House and Senate committees in full swing as well, TMA is tracking a plethora of bills on the move that could help or hurt medicine's agenda.
TMA and TOA: PROKERA Not for Optometrists
TMA and the Texas Ophthalmological Association (TOA) sent a comment letter to the Texas Optometry Board strongly objecting to a proposed rule concerning procedures authorized for therapeutic optometrists. The proposed rule, published in the March 20 edition of the Texas Register, would allow a therapeutic optometrist to "administer, perform, or prescribe ophthalmic devices, procedures, and appropriate medications administered by topical means, to diagnose or treat visual defects, abnormal conditions, or diseases of the human vision system, including the eye and adnexa."
Standing Up for Patients
The Affordable Care Act promotes collaboration and team treatment of patients. The Texas Medical Association agrees collaborative care is crucial, but the association wants to ensure physicians remain the head of the team. With the Texas Legislature in full swing, physicians face several bills that would challenge that leadership and expand the scope of practice for nurses, chiropractors, and other health professionals without a license to practice medicine.
Physicians Should Diagnose Physical Therapy Need
While physical therapists are important members of the health care team, they are neither licensed nor trained to make a medical diagnosis. A medical diagnosis serves as the foundation for physical therapy services and acts as a filter to ensure that a patient is provided the most efficient and high quality treatment possible. Correctly diagnosing a musculoskeletal condition involves a number of factors, including the performance of a comprehensive history and physical examination, and when indicated, imaging, laboratory testing, and other diagnostic procedures, none of which physical therapists have the training or capability to provide.
Delegation of Duties
Prescriptive Authority Agreement Background Information and Sample Form
The prescribing of drugs and devices is the practice of medicine. Physicians may delegate if appropriate but must supervise in accordance with the standard of care. Physicians ultimately may be held accountable for the delegation and supervision of medical acts.
Information on Delegation of Duties to NPPs
The Texas Medical Association has a number of tools to help physicians manage nonphysician practitioners (NPPs) properly. See TMA's online resources, as well as other helpful information, listed below to learn more about delegation of duties.
TMA Advocacy and Communications
TMA Advocacy and Communications
2015 Testimonies and Letters
2013 Testimonies and Letters
FTC Calls for APRN Independent Practice
(April 15, 2014)
TMA Opposes Audiology Scope Expansion
(April 1, 2014)
Supreme Court to Review Antitrust Enforcement Case
(March 14, 2014)
Board Pulls Plan for Pharmacists to Check Diagnoses
(Feb. 18, 2014)
Sample Template for Delegating and Supervising Prescribing Privileges for APRNs/PAs Under SB 406
(Nov. 15, 2013)
TMA Challenges Dentists' Sleep Apnea Rule
(July 1, 2013)
TMA Letter Challenging Dental Board Rules
(June 18, 2013)
Buried in Paperwork: Improvements in Team-Based Care Help Doctors Delegate
TMA Opposes New Chiropractic Board Rules
(Nov. 16, 2012)
Scope Whac-A-Mole: Expansion Attempts Keep Popping Up
Doctors Targeted: FTC Aims at Scope Limits
Chiropractic Neurology Rules Scrapped
(Aug. 20, 2012)
TMA: No Chiropractice Neurology
- Action (Aug. 1, 2012)
Safety Concerns: TMA Opposes Chiropractors Performing Sports Exams
Appeals Court Backs TMA in Chiro Lawsuit
(April 17, 2012)
Chiropractic Board Withdraws Scope Rules
(Feb. 15, 2012)
Dr. Austin Against Bad Chiropractic Bill HB 3441
(April 12, 2011)
Medicine Under Attack: TMA Defends Patients' Safety, Physicians' Authority
TMA Fact Sheet on Chiropractor Scope Bill
(PDF, April 6, 2011)
TMA Challenges Chiropractors Rules Again
(Jan. 4, 2011)
Foot Fight: TMA Wins Victory in Legal Battle With Podiatrists
TMA Opposes Vestibular Diagnostic Testing by Chiropractors
(Feb. 17, 2010)
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