Scope of Practice

Why patients want doctors to lead the care team

Andis Robeznieks , Senior News Writer

Confusion about who is and who isn’t qualified to provide specific patient care undermines the reliability of the health care system as a whole and can put patients at risk. That’s not the opinion of doctors protecting their “turf.” It’s what patients think.

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An overwhelming majority of patients, 88%, believe only licensed medical doctors or doctors of osteopathic medicine—MDs or DOs—should be able to identify themselves as “physicians,” according to an online survey conducted by Baselice & Associates, an Austin, Texas-based national research firm.

Patients believe that physicians’ extensive education and training is important, but only a little more than half, 55%, said that it was easy to identify who is and isn’t a physician by reading advertising and marketing materials that list what services they offer, their title, and other licensing credentials.

It is an issue patients take seriously, as 79% said they would support legislation requiring all health care advertising to clearly designate the level of education, skills and training of all health care professionals promoting their services.

The survey is one example of the AMA research and resources on scope of practice that physicians can use to effectively engage with legislators and regulators to #StopScopeCreep.

Other findings from the patient survey include:

  • 91% said a physician’s years of education and training are vital to optimal patient care—especially in the event of a complication or medical emergency.
  • 86% said patients with one or more chronic diseases benefit when a physician leads the primary health care team.
  • 84% said they prefer a physician to have primary responsibility for the diagnosis and management of their health care.
  • 75% prefer to be treated by a physician.
  • 75% said they prefer to be treated by a physician—even if it takes longer to get an appointment and costs more. 

The patient’s preference should come as little surprise, given that the difference in the education and training of physicians and other health professionals is vast. Physicians complete between 10,000 and 16,000 hours of clinical education and training—four years in medical school and another three to seven years of residency training. By comparison, nurse practitioners, for example, complete between 500–720 hours of clinical training during two or three years of graduate-level education.

Related Coverage

AMA opposes HHS move to expand pharmacists’ scope of practice

Nonphysician health professionals lobby legislatures and regulatory boards to expand their scope of practice almost every year in almost every state. While some scope expansions may be appropriate, others are not. The AMA supports physician-led team-based care with all members of the team working together for the benefit of the patient,

Learn with the AMA about these four tips for physician advocates to protect the doctor-led care team.

Stopping scope creep

In collaboration with state medical and national specialty societies, the AMA secured more than 70 state legislative victories stopping inappropriate scope expansions of nonphysicians in the past two years.

These included successful efforts to stop:

  • Nurse practitioner (NP) independent practice.
  • Independent practice of nurse anesthetists.
  • Independent practice of physician assistants.
  • Independent prescribing of psychotropic drugs by psychologists.
  • Optometrists from performing surgical procedures.
  • Pharmacist prescribing.

Related Coverage

3 big reasons why letting NPs practice independently is a bad idea

This success is partly due to demonstrating that scope expansion does not equal expanding access to care using the AMA Health Workforce Mapper. The tool helps demonstrate that 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.

Also, despite the rising number of NPs across the country, regional clinician shortages still persist in states that allow independent NP practice.