Scope of Practice

AMA opposes HHS move to expand pharmacists’ scope of practice

Andis Robeznieks , Senior News Writer

What’s the news: The AMA opposes a new declaration from the U.S. Health and Humans Services Department (HHS) that allows pharmacists and pharmacy interns to administer vaccines to children between three and 18 years old. 

The declaration notes that “many states already allow pharmacists to administer vaccines to children of any age.” But AMA President Susan R. Bailey, MD, called this claim misleading.

Subscribe to AMA Advocacy Update

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

“Many of these states have important protocols in place, such as requiring a prescription or order from a physician,” said Dr. Bailey, an allergist and immunologist in Fort Worth, Texas.

Why it’s important: HHS describes the recent drop in childhood-vaccination rates as “a collateral harm caused by COVID-19,” and states that the declaration was needed to address this “public health threat.”

Each member of the physician-led health care team has an important role to play while working together to ensure improvements in patient care, but COVID-19 doesn’t require an end-run around scope-of-practice laws.

Dr. Bailey said allowing pharmacists to administer vaccinations is the wrong solution.

Related Coverage

Independent practice for NPs fails to solve rural access problems

“While we acknowledge that childhood vaccinations have significantly declined during the pandemic, preempting state licensing laws to expand pharmacists’ scope of practice is not the solution to vaccine hesitancy and will create additional problems,” she said.

These problems include the further fragmentation of children’s health care.

“It will likely cause children to forgo holistic well-child exams and comprehensive preventive care, early diagnosis, optimal therapy, and ensured timely vaccinations that are necessary to safeguard children’s health, especially during a pandemic,” Dr. Bailey explained. 

“Pediatricians’ and family physicians’ practices are open and ready to provide the comprehensive preventive care parents and patients expect,” Dr. Bailey added. “We urge HHS to reconsider the negative health repercussions of funneling children away from their primary care physicians and rescind this declaration.”

An AMA checklist provides helpful step-by-step guidance to manage the safe reopening of practices in a manner that protects patients, clinicians, staff, and the public. AMA resources also include a pre-visit screening script designed to balance patients’ immediate care needs while still addressing backlogged necessities that have been postponed to support the physical distancing that is necessary to curb the community spread of COVID-19.

Related Coverage

How calling CRNAs “nurse anesthesiologists” misleads patients

Learn more: In addition to opposing scope-of-practice expansion at the federal level, the AMA is working with state medical societies to oppose efforts where the pandemic is being used to promote scope-of-practice expansion for nonphysician providers at the state level.

Most recently, this includes efforts to allow advanced practice registered nurses in Georgia to order advanced diagnostic-imaging tests and to permit California nurse practitioners to practice independently.

Through research, advocacy and education, the AMA vigorously defends the practice of medicine against scope of practice expansions that threaten patient safety.