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Affordable Care Act
Scope of Practice
Healthy Vision 2020
What's Our Policy?
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
Appeals Court Rules Marriage and Family Therapists Can't Diagnose
The Texas Third District Court of Appeals handed down a favorable decision in TMA's lawsuit against the Texas State Board of Examiners of Marriage and Family Therapists (TSBMFT). The court decided marriage and family therapists cannot diagnose.
TMA Opposes Bill to Expand Audiologists' Scope
TMA and more than 110 national organizations, state and local medical associations, and state and local specialty societies delivered a clear message to members of the U.S. Congress: Oppose any efforts to give audiologists direct, unlimited access to Medicare patients without a physician referral and to include audiologists in the definition of physician. The groups outlined their opposition to House Resolution 5304 in a letter to Congress last month.
Patient Safety First
Thanks to opposition from the Texas Medical Association and other organizations, the Texas Board of Nursing (TBON) has withdrawn proposed rules that would have allowed advanced practice registered nurses to make medical diagnoses. TBON announced its proposal on the heels of another scope-of-practice debate involving dentists. In June, a new State Board of Dental Examiners rule took effect, allowing dentists to screen for and treat sleep disorders. The board adopted the rule even though TMA and the Texas Neurological Society testified against the change, pointing out its potential to harm patients with severe obstructive sleep apnea.
TMA Opposes Nurse Practitioner Plan
Proposed new rules regulating the scope of practice of advanced practice registered nurses (APRNs) would illegally allow APRNs to make medical diagnoses, and they ignore key tenets of a new state law, the Texas Medical Association and nine other state medical societies wrote in a formal comment letter to the Texas State Board of Nursing.
Licensure Should Stay Intact
What we really need are standardized processes for licensing similar to medical, dental, and nursing boards for ALL health care providers. Otherwise the burden of proof falls on facilities which employ or contract with these providers and many of those facilities do not have the infrastructure to carry out such investigations.
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)
Marriage Counselors Suit
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