Scope of Practice

Patients deserve greater clarity on who is a physician—and who isn’t

Timothy M. Smith , Contributing News Writer

AMA News Wire

Patients deserve greater clarity on who is a physician—and who isn’t

Aug 11, 2023

It’s increasingly common for patients to encounter nonphysician providers as members of their health care teams. Meanwhile, ever more nonphysician practitioners have received advanced training resulting in a doctorate degree, such as the doctor of nursing practice. 

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To help patients keep pace with these changes, physicians should make new strides to clarify their roles and credentials vis-a-vis other members of the health care team and also promote collaboration among all health professionals.

The core issue is that “the skill sets and experience of nonphysician practitioners are not the same as those of physicians,” according to an AMA Council on Ethical and Judicial Affairs report that was adopted at last year’s AMA Interim Meeting. Thus, when nonphysician providers identify themselves as “doctors”—consistent with the doctoral-level degrees they earned—“it may create confusion and be misleading to patients and other practitioners,” says the report.

In fact, surveys (PDF) performed as part of the AMA Truth in Advertising Campaign have found that while patients strongly support physician-led health care teams, many are confused about the level of education and training of health professionals—and the confusion isn’t limited to nonphysician providers who hold doctorates. For example, roughly one-fifth of respondents think psychiatrists are not physicians, while a similar number think nurse practitioners are physicians.

The AMA Code of Medical Ethics touches on this issue in an opinion on collaborative care, which provides guidance on the roles of physicians in team-based settings where a mix of health professionals provide care.

Related Coverage

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Communicate about the team

To help ensure patients get the best care and understand who is caring for them, the AMA House of Delegates amended the opinion on collaborative care to provide advice about transparency in the context of team-based care involving nonphysician practitioners.

“Health care teams often include members of multiple health professions, including physicians, nurse practitioners, physician assistants, pharmacists, physical therapists and care managers among others,” the amended opinion says. “To foster the trust essential to healing relationships between patients and physicians or nonphysician practitioners, all members of the team should be candid about their professional credentials, their experience and the role they will play in the patient’s care.”

In addition, as clinical leaders within health care teams, individual physicians should “communicate appropriately with the patient and family, respecting the unique relationship of patient and family as members of the team,” as well as “assure that all team members are describing their profession and role.

At the same time, as leaders within health care institutions, physicians individually and collectively should “promote a culture of respect, collegiality and transparency among all health care personnel.”

Patients deserve care led by physicians—the most highly educated, trained and skilled health care professionals. Learn how, as part of the AMA Recovery Plan for America’s Physicians, the AMA is fighting inappropriate scope of practice expansions that threaten patient safety.

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Become a member and help the AMA defend against scope of practice expansions that threaten patient safety.

Find out in detail why education matters to medical scope of practice, with information on:

  • Nurse practitioners compared with physicians.
  • Physician assistants compared with physicians.
  • Nurse anesthetists compared with anesthesiologists.
  • Psychologists compared with psychiatrists.
  • Naturopaths compared with physicians.

Visit AMA Advocacy in Action to find out what’s at stake in fighting scope creep and other advocacy priorities the AMA is actively working on. 

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