States nationwide are debating whether to expand the scope of practice for advanced practice providers, especially in three main specialties, according to an April 5 report from the American Medical Association.
Physicians say such an expansion, dubbed "scope creep," will harm patient safety, while advanced practice providers argue it will improve access to care and that they are qualified to provide a wider range of care.
Three specialties pushing against scope creep:
1. Ophthalmology: Ophthalmology organizations are fighting efforts to allow optometrists to perform eye surgeries. In October, the California legislature passed a bill that would have allowed optometrists to perform laser and scalpel eye surgeries, procedures typically performed by ophthalmologists. The bill was opposed by the American Medical Association and vetoed by California Gov. Gavin Newsom.
2. Anesthesiology: Several states, including New Jersey and West Virginia, have proposed legislation expanding the scope of practice for certified registered nurse anesthetists, allowing them to work without physician supervision. Two U.S. representatives want to expand the scope of practice for CRNAs nationwide.
3. Psychiatry: This year, there was a nationwide push for Medicare to define psychologists as physicians, allowing them to prescribe medications without reporting to an attending primary care physician. The AMA sent a letter to Capitol Hill to oppose the proposal.