Scopes of practice are intended to encompass the education and clinical training that a healthcare provider earns through their degree(s) and approved continuing education. Education is accredited by recognized agencies. (This policy is not in reference to expansion for PAs and NPs who would be expanding the definition and pivoting to a different education focus of their chosen field with such an expansion. From bedside nursing and assitance to a Doctor who is trained differently throughout their entire education. That is a different topic which is being addressed in other policies. )
Unfortunately, several groups see the creation of individual State Scopes of Practice as a way to limit competition and reduce responsibility to pay for care. This includes the AMA and entities connected to them such as Medical Boards and Associations, the insurance industry, and Medicare to name a few.
The AMA has written an extensive policy on scope of practice including opposing legislation that allows the independent practice of competitive professionals and strongly supporting MD/DO only led team care. AMA works closely with state and specialty medical societies and uses Attorneys to fight against Boards to address such efforts.
The Insurance Industry will support limited scopes of practice as on the surface it will decrease their expense and allow them to keep money from premiums invested in the stock market. The insurance industry is one of the corporations permitted to invest premiums into the stock market. Thus it is beneficial to limit in any way they can the payout for healthcare.
Medicare is known to pay less than cost for services rendered and limits scopes of practice further than State scopes of practice in order to further reduce payments. It is also known that funds for Medicare are used to pay down government debt unrelated to healthcare. See
We propose a policy that prevents the States, Boards, Association, and Insurance (and any other involved individual, group or entity etc) from writing scopes of practice and definitions which restrict or limit the scope of practice or definition of a Doctorate level provider who has received a 5 year didactic equivalent preceded by a BS. All Boards, Scopes, Insurance policies or similar regulating bodies must recognize in the scope of practice and in the definition the broadest practice provided to the profession by their education and continuing education.
Healthcare Providers are educated and see patients prior to graduation. They are required to take Board examinations and have passing scores on all material. In addition, they are licensed by States where they must pass additional Jurisprudence examinations and undergo background checks. They are further required to obtain continuing education credits which are approved with connection to a graduate school or association. Thus the practice that a provider may participate in should not be limited based on competitive motives put under the guise of protecting the public when providers are prepared through education and testing both in school and through extensive Board examinations. This is a detriment to the patients being served and also puts a financial burden on the economy. This burden is through chronic illness that could be combatted with the ability of highly trained professionals to practice to their full education and continuing education and also puts a financial burden of student loan repayment issues on the economy. Chronic illness adds to economic hardship when individuals are not able to function fully and become burdened with fewer choices in types of specialists and types of care due to the limiting of scopes. Doctorate level education may cost as much as $200,000 to 300,000. If providers cannot practice to their full education due to the competitive limiting of scopes of practice those student loans cannot be afforded. While many people do not want to face the hardship of student loan burden this is an unnecessary hardship created through unfair practice of writing Scopes of practice and definitions that do not allow healthcare providers with Doctorate level education to practice to their full education and continuing education.