Advocacy Update

July 28, 2023: State Advocacy Update


Physician burnout can lead to devastating consequences for individual physicians, patients, the physician workforce, and the U.S. health care system as a whole. Dealing with burnout requires system-level solutions, as well as initiatives and programs that provide protections to help encourage physicians and medical students to seek help when needed and improve their practice environment.

Haven't subscribed?

Stay current on the latest on the issues impacting physicians, patients and the health care environment with the AMA’s Advocacy Update newsletter.

Support for enhancing physician wellness is growing. For example, a number of state medical associations have both successfully enacted laws that provide confidentiality protections for physicians seeking help for burnout, and the AMA has worked closely with state medical associations to urge state medical boards to eliminate or revise stigmatizing mental health related questions on licensing applications to match AMA policy and lower barriers to physicians from seeking help. 

Register now for this new AMA Advocacy Insights webinar on Aug. 23 at Noon Central.

Join the chair of the AMA Board of Trustees Willie Underwood III, MD, MSc, MPH, in conversation with expert panelists who are working with the AMA in advocating for such changes—and implementing them. 

Hear from:  

  • Mark Staz, management consultant, Regulatory Policy, Federation of State Medical Boards, about how FSMB is changing licensing questions to remove stigmatizing questions that often serve as a barrier to care 
  • Barb Smith, chief executive officer, South Dakota State Medical Association, about how the association advocated to have its state board change licensing questions to support physician wellness 
  • Abraham Segres, vice president, quality and patient safety, Virginia Hospital & Healthcare Association, about how the association is leading efforts to get all VA hospitals and systems to make positive changes to support physician wellness—and attract new physicians to its workforce 
  • Joel Bundy, MD, vice president, chief quality and safety officer, Sentara Healthcare, about how the health system identified changes needed and the steps it took to implement and communicate changes across the system 

Register now

As state legislative sessions come to a close, Scope of Practice Partnership (SOPP) grantees are reporting positive results. New York state is among them, seeing overwhelming success in the face of over a dozen scope of practice bills. In the upcoming weeks and months, AMA Advocacy Update will highlight the advocacy successes of select Scope of Practice Partnership grant recipients—starting with New York.   

Since its inception in 2007, the SOPP has awarded over $3.5 million in grants to medical societies, funding initiatives to fight inappropriate scope of practice expansions, promote truth in advertising and protect physician-led care. The SOPP is a collaborative effort staffed by the AMA and comprised of the AMA, the American Osteopathic Association, 18 national specialty societies, 50 state medical associations and 39 state osteopathic medical associations. This year, the AMA boosted its commitment to the SOPP, helping the partnership extend its support to 14 state medical societies, an increase from 9 grantees in 2022.  

The Medical Society of the State of New York (MSSNY) is among the 14 state medical societies who received funding from the SOPP to support state-level scope of practice advocacy during the 2023 legislative session. MSSNY faced an uphill battle on the scope of practice front this year, as numerous scope expansions were included in the Executive budget and at least 15 nonphysician scope expansions were proposed in the legislature. Among these proposed expansions was a bill that would have authorized physician assistants to practice independently. Another bill would have permitted pharmacists to test for and treat potentially serious illnesses over the pharmacy counter. These scope of practice expansions put patients at risk—and were ultimately defeated by MSSNY.  

In addition to top-notch lobbying efforts, MSSNY’s scope of practice success is attributable to a statewide communications campaign, funded in part by the SOPP. Using funds from the SOPP, MSSNY created radio advertisements (MP3) that played throughout New York state, alerting New Yorkers to scope of practice expansion proposals, and calling out the differences in education and training between physicians and nonphysicians such as physician assistants and pharmacists. These radio advertisements were supplemented by promoted social media highlighting the negative impact to patients when physicians are removed from the health care team.  

Other scope of practice wins in New York include the defeat of a bill—which AMA opposed in a letter to the state legislature—that would have allowed psychologists to prescribe powerful psychotropic medications, defeat of multiple bills that would have expanded the scope of practice for certified registered nurse anesthetists (CRNAs), defeat of a bill that would have created a license for naturopaths and others. In the face of all this, MSSNY was wildly successful in the 2023 legislative session, defeating all but one inappropriate scope expansion in New York this year.  

(The one scope expansion that did pass authorizes pharmacists to dispense contraceptives pursuant to a global order by a prescriber—but it also requires pharmacists to undergo special training and notify the patient’s primary care provider that the contraceptives were dispensed, making it one of the country’s more controlled pharmacist contraceptive-dispensation laws.) 

MSSNY’s success serves as a compelling example to state medical societies and demonstrates the powerful impact of the SOPP.