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Advocacy victories

For over 30 years, the AMA’s state and federal advocacy efforts have safeguarded the practice of medicine by opposing nurse practitioner (NP) and other nonphysician professional attempts to inappropriately expand their scope of practice.

50 scope of practice victories in 2019

In 2019, the AMA secured over 50 state legislative victories stopping inappropriate scope expansions of nonphysicians. This work was done in strong collaboration with state medical and national specialty societies, including:

—NPs & independent practice (AR, CA, FL, IL, IN, LA, MS, MT, OH)
—Nurse anesthetists & opt out of Medicare supervision (CO, MS)
—Nurse anesthetists & independent practice (AR, IL)
—Nurse midwives & independent practice (NE)
—Physician assistants & independent practice (IL, LA, ME, MT, NV, OR)
—Psychologists & independent prescribing of psychotropic medications (CT, FL, HI, IL, MT, VT)
—Optometrists & surgery (MD, ND, VT)
—Pharmacists & prescribing (AZ, IA, IL, IN, VT)
—Naturopaths & licensure (CT, IL, MD, OR)
—Physical therapists & direct access (AL)
—Podiatrist & surgery of lower leg (ME)

More than $2 million in grants awarded

The AMA recognizes the importance of the house of medicine working together, which is why it formed the Scope of Practice Partnership (SOPP) in 2006. Today, the SOPP is comprised of 105 national, state and specialty medical associations. The SOPP has awarded more than $2 million in grants to its members to fund advocacy tools and campaigns. 

Produced 100s of tools to fight scope expansion

The AMA is one of the only national organizations that has created more than 100s of advocacy tools for medicine to utilize when fighting scope expansion legislation and regulation including model bills, legislative templates, state laws analyses, issue briefs and more.

Demonstrated scope expansion does not equal expanding access to care

The AMA has created over 1,000 geomaps, along with the Health Workforce Mapper (members-only and non-members versions), to demonstrate that expanding scope does not equal expanding access to care.

For instance, AMA research shows the following:

—Nonphysician providers (such as NPs) are more likely to practice in the same geographic locations as physicians. This is true even in states that allow NPs to practice independently.
—Despite the rising number of NPs across the country, health care shortages still persist, even in states that allow NPs to practice independently.

Engagement with the FTC and administration

The AMA has proactively engaged the Federal Trade Commission (FTC) when necessary and responds to FTC enforcement against state licensure board actions related to scope of practice.

Also, the AMA is working with the administration to preserve physician supervision of nonphysician professionals in Medicare.

Launched the AMA Truth in Advertising campaign

The AMA launched the Truth in Advertising campaign, which has been enacted in over 20 states, informing the public about who is and is not a physician. The campaign is designed to ensure health care providers clearly and honestly state their level of training, education and licensing. 

Distributed educational wheels 

The AMA has distributed 1,000s of “Education Matters” wheels, to legislators and regulators across the country, that compare the education and training of physicians and nonphysicians.

Elimination of the APRN multistate licensure compact

After convening states and specialties, the AMA eliminated the 2015 Advanced Practice Registered Nurse Multistate (APRN) Licensure Compact by defeating every proposed state bill over the last two years.

Key research & resources

The AMA’s research provides overwhelming proof that patients want physicians to lead their medical care and the advocacy roadmap.

—Four out of five patients prefer having physicians lead their health care team.
—Seventy-five percent of patients prefer to be treated by a physician.
—Ninety-one percent of patients said that a physician’s years of education and training are vital to optimal patient care, especially in the event of a complication or medical emergency.
—Physicians and nonphysicians practice in the same locations—largely in the highly populated areas of a state.

Resources that set the record straight for policymakers

Draw on issue briefs, model legislation, state bar charts and other resources for background on major topics related to scope of practice.