Scope of Practice

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.

Buried in Paperwork - 01/14/2021

The Texas Medical Association reached a landmark agreement with advanced practice nurses and physician assistants on legislation to improve patients' access to care through an improved delegated model for team-based health care. The bill helps establish a more flexible and collaborative practice model that improves on current site-based restrictions.

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.

I Won’t Take the Nurse Practitioners’ Bait - 04/09/2020

The American Association of Nurse Practitioners (AANP) is obviously intent on picking a fight with physicians. No thanks. We’ll take the high road, fully aware of the dangers of their plans, and stick with what we know is best for our patients: the physician-led health care team.

TMA Opposes Attempts to Expand Audiologists’ Scope - 02/14/2020

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.

TMA to Trump: Do Not Expand NPPs’ Scope of Practice - 02/12/2020

When President Donald Trump released an executive order earlier this month that would, in part, expand the scope of practice of nonphysician practitioners, the Texas Medical Association vowed to keep physicians at the head of the health care team. On Monday, TMA President David Fleeger, MD, took a major step to do that, urging President Trump and Health and Human Services (HHS) Secretary Alex Azar to remove that language entirely.

Physicians Must Lead Care Teams, Medicine Tells Feds - 01/24/2020

The Texas Medical Association, and 99 other medical societies, are making it clear to Medicare that physicians are the nation’s most highly trained health care professionals – and the government shouldn’t weaken or eliminate their supervision of nonphysicians.

TMA Says “No” to Federal Scope Expansion Under President’s Medicare Executive Order - 01/23/2020

At least one piece of President Donald Trump’s recent executive order on Medicare will meet strong opposition from the Texas Medical Association. “Know this: TMA will stand up for our profession and our patients to prevent this totally unwarranted scope-of-practice expansion from becoming reality,” said TMA President David C. Fleeger, MD.

CRNAs Can’t Administer Anesthesia Unless Physician Delegates It, AG Rules - 09/12/2019

The state attorney general has agreed with the Texas Medical Association in an official opinion that keeps certified registered nurse anesthetists (CRNAs) from administering anesthesia without physician delegation.

Respecting the Roles: TMA Battles Another Round of Scope of Practice Bills - 08/02/2019

When nonmedical professionals ask the Texas Legislature for the authority to practice medicine, TMA mounts a full-court press, letting lawmakers know why there are some roles only physicians can fill.

Scope of Practice: Shot Down - 08/02/2019

When it comes to shooting down dangerous attempts to expand non-medical practitioners’ scope of practice, TMA’s advocacy army once again proved to be expert marksmen in 2019. Medicine trained its scope on bills that would have allowed nurse practitioners, chiropractors, and optometrists, among others, to wade into the practice of medicine.