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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
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."
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.
Tax Relief, Medicaid Primary Care Pay Bump in Sight; Scope in Crosshairs
As hearings get under way and lawmakers scramble to fashion a budget at the halfway mark of the 2015 legislative session, graduate medical education funding and tax relief remain a focal point for the legislature, and the House of Medicine has made early progress on both fronts. Lawmakers also heard TMA's call to reinstate the Medicaid-Medicare parity payments for primary care.
Don't Allow Chiropractors to Issue Handicapped Parking Placards
Opposed to HB 126 by Fletcher: Despite the fact that we may agree that it seems there are many handicapped placards in use today, the determination of who may – or who should – use such a placard truly amounts to a medical determination of significant disability. It seems logical to me as a physician that an individual who might quality for such a determination SHOULD be under the ongoing care of a physician licensed to practice medicine.
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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