Scope of Practice

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.

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.

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.

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.

The Texas Society of Anesthesiologists is questioning a Corpus Christi hospital’s decision to replace its long-time anesthesiology team with a group it says appears ready to give certified registered nurse anesthetists more autonomy than Texas law allows.

TMA has a number of tools to help physicians manage nonphysician practitioners (NPPs) properly.

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.