Scope of Practice

Prohibit Chiropractors From Practicing Neurology - 04/29/2019

The current statutory definition of chiropractic references its focus on the musculoskeletal system. SB 1867 would add “neuro” to its definition. We find this an unwarranted expansion, contrary to patient health care, and unsupported by chiropractors’ education and training.


Chiropractors Are NOT Neurologists – Don’t Expand Their Scope - 04/03/2019

Simply alleging that the basis of this proposal is the impossibility of treating conditions related to the “musculoskeletal” system without a neurological connection is misleading, oversimplified, and potentially dangerous. Adding the term “neuro” is not merely the addition of the nerves that may connect muscle tissue or bones. It is the addition of the entire neurological system that includes the brain, the spinal cord, and the regulation of many bodily functions – all well beyond chiropractors’ education and training.


Stop APRN Scope Expansion - 04/03/2019

Medical school was a very humbling experience as I learned the depth of what I did not know as a nurse practitioner. Many times I realized I had inadvertently provided improper treatment for a patient simply out of ignorance. I came to realize, for example, the reason I struggled to understand how to interpret lab data as a nurse practitioner was that I hadn’t gained the in-depth knowledge of normal physiology and abnormal pathophysiology required to understand the “why” behind the lab tests.


Respecting the Roles: TMA Battles Another Round of Scope of Practice Bills - 03/28/2019

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.


Pharmacy Board Nixes Proposal That Could’ve Broadened Pharmacists’ Scope - 03/14/2019

Medicine’s objections were strong, and the state’s draft rules allowing pharmacists to perform medication therapy management services aren’t going to make it after all.


Healthy Vision 2025 Calls for Teamwork, not Scope Expansion - 02/07/2019

The sentence has appeared in every edition of the Texas Medical Association’s Healthy Vision series since the first Healthy Vision 2010 was published 14 years ago: “TMA opposes any efforts to expand any health professionals’ scope of practice beyond what is safely permitted by their education, training, and skills.” That focus on safety remains an integral part of  Healthy Vision 2025 , published last week. And that sentence remains, verbatim.    


Help TMA Fight Independent Practice For APRNs - 02/07/2019

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.


The Eight Years’ War: Court Sides With TMA in Long-Running Chiropractic Case on Vestibular Testing - 02/04/2019

In a split victory, TMA once again prevailed in November 2018 when the Third Court of Appeals upheld a trial court’s decision that chiropractors don’t have the authority to perform vestibular-ocular-nystagmus testing (VONT). However, a recent change to state law caused the appeals court to find in the Texas Board of Chiropractic Examiners’ (TBCE’s) favor on the use of the word “diagnosis” in the board’s administrative rules — meaning chiropractors can diagnose, but only within their scope of practice.


Opioid Overreach? State, Retail Pharmacy Policies Prompt Scope-of-Practice Concerns - 12/07/2018

Worries over what’s been termed a national opioid epidemic is leading to new state and corporate pharmacy policies that could blur the line between the practice of pharmacy and the practice of medicine.


Physicians Warn of Overreach in New Pharmacy Prescription Rules - 12/05/2018

Physicians are questioning whether some Texas pharmacists are overstepping bounds by using a new rule to second-guess whether a doctor’s prescription is appropriate.


Specialties List Scope, Balance Billing Among Top Targets for 2019 - 12/04/2018

Representatives of more than 20 specialty societies ran through each organization’s top priorities for the 2019 Texas Legislature during the Texas Medical Association’s annual Advocacy Retreat on Saturday morning at the Renaissance Austin.


Should Texas Change the Rules for APRNs? - 11/13/2018

Texas is facing a chronic physician shortage, especially in rural areas and urban cities. Some argue that giving advanced practice registered nurses more leeway to prescribe and treat patients will help address that shortage. But is that a workable solution? A panel discussion at the Texas Public Policy Foundation, a conservative think tank in Austin, set out last week to address this contentious issue.


Advanced Education? TMA Pushes State for Standards in APRN Clinical Training - 10/18/2018

TMA pushes state for standards in APRN clinical training.


Financial Squeeze: Low Medicaid pay has Dallas clinics turning to midlevels to cut costs - 09/14/2018

Low Medicaid pay forces some Children's Health Pediatric Group clinics in Dallas to close, others turn to midlevels to cut costs, raising quality concerns.


Proposal Would Maintain Unauthorized Scope for Chiropractors - 08/21/2018

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.


Physician Assistants to Explore Changing Title - 06/04/2018

Physician assistants one day might go by a different name under a resolution the American Academy of PAs passed during its annual conference in May.


Medical Associations Challenge Nursing Council - 05/17/2018

The TMA, AMA, and other state medical societies are asking the National Council of State Boards of Nursing to remove or revise parts of an interstate compact that would alter state scope-of-practice laws for advanced practice registered nurses.


TMB Should License Neurodiagnostic Technicians - 04/27/2018

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.


Standing Up for Patients - 04/25/2018

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.


Keep Team-Care Model; Do Not Grant APRNs Autonomy - 03/21/2018

This opinion column (op-ed) by Don R. Read, MD, president of the Texas Medical Association (TMA), expresses concerns over efforts by some nursing groups to attain independent practice authority rather than working collaboratively with Texas physicians. The concept is proposed in House Bill 1415 by Rep. Stephanie Klick and Senate Bill 681 by Sen. Kelly Hancock, both of Fort Worth.


Delegating and Supervising Prescribing Privileges for APRNs/PAs - 09/27/2017

New state law governing the delegation and supervision of prescribing privileges for advanced practice registered nurses and physician assistants went into effect Nov. 1.  


Stop These Bad Scope Bills Now - 05/05/2017

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Court Sides With TMA in Final Ruling on Chiropractic Scope of Practice Lawsuit - 01/10/2017

We won! In a final judgment by Travis County District Court Judge Rhonda Hurley, TMA prevailed in its long-held declaration that the Texas Board of Chiropractic Examiners' (TBCE's) rules permitting chiropractors to make medical diagnoses and perform other medical procedures exceed the chiropractic scope of practice.


Partial Victory for Medicine in New VA Policy - 12/15/2016

Nurse anesthetists have been excluded from a new Department of Veterans Affairs' (VA's) policy that permits certified nurse midwives, nurse practitioners, and clinical nurse specialists to practice independently of direct physician supervision. Certified registered nurse anesthetist (CRNA) anesthesia practice will continue to require anesthesiologist supervision.


Texas Physicians Debate Complementary and Alternative Medicine Therapies' Role in Health Care - 10/25/2016

Texas physicians have varying opinions about CAM therapies to treat a patient’s collective mind, body, and spirit. While some embrace various CAM treatments in their practice, others are cautious and avoid them. But wherever physicians stand on CAM, all agree on the need to place patient safety first, according to Texas Medicine , the Texas Medical Association’s (TMA’s) monthly magazine. That means staying informed on the latest CAM therapies to answer patient questions, and verifying that any alternative therapies patients are taking will not conflict with conventional medicine.