Scope of Practice

TMA Opposes Attempts to Expand Audiologists’ Scope - 07/17/2023

Proposed federal laws that would give audiologists unlimited access to Medicare patients without a physician referral could lead to lasting, and expensive, harm to patients, medicine once again told U.S. Senate and House leadership this week.

Proposal Would Maintain Unauthorized Scope for Chiropractors - 07/17/2023

The Texas Medical Association strongly opposes proposed new state rules that would continue to allow chiropractors to practice acupuncture and to perform other procedures and services outside the scope of practice for chiropractic.

Removing Texas Physicians From the Health Care Team Would be Harmful, Costly - 05/04/2023

Op-ed by Texas Medical Association (TMA) President Gary W. Floyd, MD, and Board of Trustees Chair G. Ray Callas, MD, about legislation proposing to give advanced practice registered nurses and other providers independent practice authority without physician supervision.

Help TMA Fight Independent Practice For APRNs - 05/02/2023

Please contact your state lawmakers today through the new TMA Grassroots Action Center. Let them know you support physician-led, team-based care. Tell them how much you learned in your years of medical school, residency, and beyond. Tell them why APRNs are NOT the answer to Texas’ physician shortage. Ask them to say “No” to the APRNs and to help the Texas Medical Association stop them.

Medicine Blasts Scope Attacks at the Texas Legislature - 04/24/2023

Nonphysician practitioners (NPPs) are redoubling their efforts on behalf of scope-of-practice expansion this session, including a pair of bills that seek full independent practice authority for advanced practice registered nurses (APRNs). But the Texas Medical Association is pushing back with equal force, armed with a growing body of research that shows removing physician oversight of the health care team undermines patient safety and health care cost containment.

TMA Decries Scope Bills That Would Allow Nurses to Practice Independently - 04/24/2023

Just three days before the bill-filing deadline, state lawmakers filed a pair of bills that would allow advanced practice registered nurses to practice independently.

TMA’s “Battle This Session” Begins: Fighting Scope Creep - 03/16/2023

As expected, several scope-of-practice expansion attempts have crept their way into the more than 800 bills the Texas Medical Association is already tracking so far this legislative session, underscoring why fighting scope creep is medicine’s top priority.

Legislative Priority #1: Scope of Practice Encroachments, Graduate Medical Education Funding - 01/06/2023

Goal Protect independent medical diagnosing, treatment, and prescribing as the practice of medicine address workforce shortages in a way that ensures all patients have access to the same standard of care and keeps pace with Texas’ outsized population

TMA Joins Fight Against Scope Creep in “Sweeping” Federal Legislation - 11/21/2022

Organized medicine is banding together to oppose a piece of federal legislation that advocates say would expand the scope of practice for nonphysician practitioners (NPPs) like nurse practitioners and physician assistants at the expense of Medicare and Medicaid patients.

Study: Nonphysician Practitioners “Should Not Function Independently” - 04/21/2022

The recent experience of a Mississippi clinic adds another piece of evidence to support one of TMA’s enduring philosophies: Health care teams should be physician-led. The clinic analyzed how both physicians and nonphysician practitioners performed in a primary care role.  

TMA Opposes Proposed Title Change for Physician Assistants - 03/08/2022

The American Academy of PAs (AAPA) passed new policy last week changing the profession’s official title to “physician associate” rather than the traditional “physician assistant” (PA).

Commentary: Hey Texas, Time to Stop Using the Word Provider! - 08/02/2021

The growing unwillingness to highlight the differences in training, education, and expertise between physicians and other health care professionals constitutes an increasing danger to not only our profession but also to patients, our health care system, and society as a whole. Patients deserve to know who is rendering their care. It is our hope that every physician reading this article will think and act in some way to speak up against the “provider” label and help reclaim the rightful title. Our profession is thousands of years old, so let’s not be the generation that destroys its own name. For the sake of those who follow in our footsteps, let’s take a stand together today.

Survey: Physicians’ Office Favored Over Retail Clinics, Urgent Care Centers - 06/23/2021

Retail clinics and urgent care centers may be as ubiquitous as Whataburger or Subway these days, but physicians’ offices “remain the public’s favored site of care,” according to a recent survey by Morning Consult.

Bad Scope Bills Defeated - 06/11/2021

Among other ill-advised proposals put forth during this year’s session, the House of Medicine stopped every troublesome attempt by nonmedical professionals to creep into the practice of medicine during this session.

The Graveyard: Scope Bills That Are No Longer a Threat, Thanks to TMA - 05/17/2021

There are still 13 days left until the House of Medicine can officially breathe easy on lawmakers’ most misguided ideas. But thanks to the Texas Medical Association’s diligence at the Capitol, many of the most dangerous state bills of 2021 have officially gone to the Texas Legislature’s graveyard.

As Scope Defenses Continue, TMA Opposes Treatment Expansion for Midwives - 05/04/2021

Throughout the 2021 session, troublesome bills to expand nonphysicians’ scope of practice have collectively been a sleeping monster – kept dormant by the House of Medicine’s dogged advocacy efforts, but in constant need of monitoring should the beast awaken.

Legislative Hotline: Independent Prescribing for APRNs: A Bad Idea - 03/24/2021

The house of medicine sent a handful of its advocates into the ring to stop this year’s effort to give advanced practice registered nurses (APRNs) more authority to perform medical acts without physician supervision.

A Busy Tuesday for Medicine: Dangerous Eye Surgeries, Extended Postpartum Coverage, Prior Authorization - 03/23/2021

Organized medicine sent an army of physicians – including TMA President Diana Fite, MD – to tell senators why a bill giving therapeutic optometrists the authority to perform a lengthy list of surgical procedures is a short-sighted idea.

Scope Expansion Bills Moving Forward. Help TMA Protect Health Care - 03/22/2021

Scope of practice will take center stage this week as the Texas Medical Association keeps its eye on and fights bad legislation that would give non-medical professionals the authority to practice medicine.

Protect Patient Safety With Physician-Led Health Care Teams - 02/03/2021

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. Physician-led 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 physicians managing the overall direction and coordination.

State Supreme Court Sides With Chiropractors on Neurological Test - 02/02/2021

The Texas Supreme Court has ruled that chiropractors can perform a diagnostic test used to evaluate a patient’s eye movements, a setback for medicine in a 10-year court battle.

VA Waives State Scope Laws for Nonphysician Practitioners - 11/11/2020

The U.S. Department of Veterans Affairs (VA) is waiving state scope-of-practice laws in an interim rule that takes effect Thursday, effectively allowing VA nonphysician practitioners to practice across state lines at VA facilities without physician overs

TMA Opposes Bill Defining Clinical Psychologists as Physicians in Medicare - 09/28/2020

A broad swath of organized medicine, including the Texas Medical Association, is asking congressional leadership to oppose a bill that legally would consider clinical psychologists to be physicians within Medicare, saying it “inappropriately” expands psychologists’ scope of practice.

Docs Must Supervise Delegation to CRNAs, TMA Tells Attorney General - 09/21/2020

Texas Attorney General Ken Paxton should state that certified registered nurse anesthetists (CRNAs) require physician supervision when a physician delegates medical acts to them, the Texas Medical Association told the attorney general in response to a request for opinion.

Some Clarity, Some Fog: AG Opines on Physician-Optometrist Relationship - 07/01/2020

An opinion by the Texas attorney general will keep the Texas Optometry Board (TOB) from exerting influence over the practice of medicine – to a certain point.