2005 Legislative Compendium: Scope of Practice

Over the past decade, every legislative session has involved scope of practice conflicts between organized medicine and allied health practitioners. In each, medicine successfully fended off nonphysicians' attempts to practice medicine, or developed collaborative agreements to improve patient care while assuring physicians continue to lead the medical team.

Despite that successful history, scores of allied health care professionals began the 79th legislature confident that the time had finally arrived for them to expand their legal scope of practice. Optometrists were after authority to manage glaucoma and perform surgery. Podiatrists wanted to operate above the foot. Other allied health providers also thought the time was right to win more clinical independence.

Many of these practitioners had contributed freely to newly elected legislators. They lined up bill sponsors. And they knew that this session would provide a host of must-pass bills onto which they could tack scope-expanding amendments. The Texas State Board of Medical Examiners and nearly all of the allied health regulatory boards were up for sunset review - the once-every-12-years government housecleaning in which an agency must be re-created by legislation, or die.

TMA and 11 other medical and specialty societies coalesced into PatientsFIRST, dedicated to protecting public safety. Coalition members collaborated to oppose any attempt to expand allied health practitioners' scope of practice beyond what their education, skills, and training safely allow.

In April, only the optometry and podiatry challenges were still moving. Physicians of all specialties collaborated to make sure they didn't move far. Patient safety issues dominated the debate, with organized medicine roundly demonstrating that only physicians have the clinical expertise and training to perform services sought by allied health groups. The sponsors of the sunset bills - especially Sen. Jane Nelson (R-Lewisville) and Rep. Burt Solomons (R-Carrollton) - kept their promises to keep those bills "clean." In the end, organized medicine triumphed. The 79th legislative session ended without one single expansion of a nonphysicians' scope of practice.

Scope of Practice TMA Staff Contacts:  

  • Yvonne Barton, Legislative Affairs, (512) 370-1359
  • C.J. Francisco, JD, Office of the General Counsel, (512) 370-1339 

Overview  | Tax Reform | Physician Ownership | Inadequate Health Plan Networks (Balanced Billing) | Managed Care/Insurance Reform | Texas State Board of Medical Examiners Sunset and Physician Licensure | Agency Sunset Review  | Corporate Practice of Medicine | Health Care Funding | Medicaid and CHIP | Indigent Care and the Uninsured | Workers' Compensation | Professional Liability Reform | Medical Education/Workforce | Child Health, Safety, and Nutrition/Fitness | Public Health | Border Health | Rural Health | Mental Health | Trauma/EMS | Prescription Drugs | Medical Science | Long-Term Care | Abortion | Transplantation/Organ Donation | Table of Contents