Pharmacists are not physicians. While both play important roles in health care, these roles are in no way interchangeable. That’s why the AMA has joined 80 leading physician organizations in opposing federal legislation now pending in Congress that would allow pharmacists to evaluate, diagnose and treat patients for a range of illnesses.
The legislation, the Ensuring Community Access to Pharmacist Services Act (H.R. 3164) and a companion bill in the Senate (S. 2426), would allow pharmacists to evaluate, diagnose and treat patients for a range of illnesses including influenza, strep and “public health emergencies,” among others. Because the scale of the pharmacist legislation now pending in Congress is national, its impact would be even more damaging to outcomes from siloed, delayed and incomplete care resulting from misdiagnoses or underappreciation of the severity of illness. We strongly urge Congress to reject this legislation.
Pharmacists are well-trained as medication experts, and their ability to educate patients on the safe and effective use of pharmaceuticals while watching out for harmful complications and drug interactions saves lives. But only physicians have the necessary education and training to properly examine and diagnosis patients for illness or disease and determine the appropriate course of treatment based on the individual needs of the patient; shifting that responsibility to pharmacists needlessly puts patients at risk.
Professional preparation differs sharply
These differences in education and training are substantial. Physicians earn a bachelor’s degree before completing four years of medical school. Their clinical judgment and decision-making skills are sharpened further by three to seven years of accredited residency and between 12,000 and 16,000 hours of clinical training. Research has shown that patients want and expect their health care to be led by physicians; 95% of U.S. voters recently said it is important to have a physician involved in diagnosing and treating them.
By contrast, admission to pharmacy school does not require a bachelor’s degree, but only two to three years of undergraduate prerequisites. Pharmacists complete 1,740 hours of “patient- care activities” in pharmacy school, which includes educating patients on medication usage and dosing while promoting continuity of care. There is no residency requirement, however, and pharmacists’ training does not include making a diagnosis, developing differential diagnoses and prioritizing them, conducting physical examinations or mental health assessments, nor performing primary care procedures.
While pharmacists and physicians each play important roles in a team-based approach, it is clear that the length, breadth and focus of their education and training prepare them for separate and distinct responsibilities in patient care. Pharmacists’ clinical training does not prepare them to perform physical or mental examinations, diagnose patients, interpret test results or provide primary care services.
Efforts to treat patients
In recent years, lawmakers in several states have proposed allowing pharmacists to administer and evaluate certain diagnostic tests, then prescribe medications based on test results. Such “test-and-treat” legislation includes simple lab tests with a low risk of erroneous results that have been approved by the Food and Drug Administration for home use, which are known as CLIA-waived tests. Examples of CLIA-waived tests include tests for influenza, strep, pregnancy and COVID-19, among hundreds of others.
As the Centers for Disease Control and Prevention points out, CLIA-waived tests can have serious health consequences if performed incorrectly, or if the diagnosis of serious conditions is delayed or missed entirely. And even when pharmacists are allowed to treat a condition based on the accurate results of a CLIA-waived test, they will arrive at a diagnosis without a physical exam and without a review of—or most often, without ever gaining access to—a patient’s medical history.
In these circumstances, the opportunity for misdiagnosis increases, and underlying health conditions that are contributing to or responsible for a patient’s health issue can go undetected. These concerns are heightened for certain populations, such as older patients.
For nearly two decades, the AMA has worked with more than 100 national, state and specialty medical associations societies under the Scope of Practice Partnership to protect patients by ensuring care is led by highly trained physicians. Our work with more than 40 state medical associations on scope issues has helped protect the health and safety of patients due to inappropriate scope of practice expansions nearly 100 times thus far in 2025.
Often these misguided scope bills are introduced as a way to address significant—and growing—physician shortages in areas of high need, especially rural communities. Rather than expand scope of practice for nonphysicians, patients would be better served by Congress passing bipartisan legislation to grow the physician workforce, such as the Resident Physician Shortage Reduction Act, which would significantly raise the number of Medicare-supported graduate medical education positions over the next seven years.
Going forward, the AMA will continue to work alongside our partners in the Federation of Medicine to fight inappropriate scope of practice expansions by nonphysicians at both the state and federal levels, while continuing to support physician-led care teams at every opportunity. These efforts include model bills and legislative templates on key issues tied to scope of practice, including the AMA Truth in Advertising Campaign that ensures patients know who is providing their health care, and several other related initiatives.
Patients expect and deserve the highest quality of care possible, and this is what care led by a physician allows them to receive. The AMA is committed to promoting policies that maintain access to physician-led teams as an integral element of high-quality patient care.
