Last month at the Interim Meeting of its House of Delegates, the American Medical Association (AMA) adopted Resolution 214 calling for creation of a national strategy to oppose legislative efforts that grant independent practice to non-physician practitioners through model legislation and national and state level campaigns. Additionally, through the resolution the AMA also resolves to effectively:
Oppose the continual, nationwide efforts to grant independent practice to non-physician practitioners;
Educate the public, legislators, regulators, and healthcare administrators; and
Effectively oppose state and national level legislative efforts aimed at inappropriate scope of practice expansion of non-physician healthcare practitioners, with a report back at the 2018 Annual Meeting.
While these tactics are not new, they have resulted in a number of organizations such as the American Association of Nurse Practitioners, the American Nurses Association, and the American Association of Nurse Anesthetists to issue individual statements calling for the AMA to stop these renewed efforts to restrict patient choice and access to care.
The Coalition for Patients’ Rights (CPR) believes patients want and should have access to a comprehensive choice of health care providers without undue restrictions. We advocate for the ability of all health care professionals to practice to the full extent of their ability, training, certification and licensure, and do not support policies or legislation that limit a patients’ ability to choose their health care provider or their access to high-quality, cost-effective health care.
A recent data report from the Association of American Medical Colleges found that physician demand continues to grow faster than supply. The report projected that the U.S. will be short more by 46,000 - 90,000 physicians by 2025, 25-30% of which will be in primary care. Demographics—specifically, population growth and aging—continue to be the key driver of increasing demand. Additionally, retirement decisions are projected to have the greatest impact on physician supply, with more than one-third of all currently active physicians being 65 or older within the next decade.
These projected physician shortages have the potential to significantly impact patient care access, but can be ameliorated by allowing the millions of highly trained and qualified health care professionals who are not physicians to practice at the top of their scope. Our Coalition continues to be a voice for the fact that patients want and should have access to a comprehensive choice of health care providers without undue restrictions. As the discussion around physician shortages continues, we believe it is important to message the positive trend that non-M.D./D.O. health care professionals are growing in numbers and are qualified and licensed to perform a wide range of health care services, which can fill many of the shortage gaps. This will be an important area of focus for CPR over the next few years as our priority is to ensure that state legislative and regulatory barriers that prevent non-M.D./D.O. health care professionals from practicing to their full scope be revised to better reflect the demands of the current health care system.
November 20, 2017
December 4, 2017
On Nov. 7, the Federal Trade Commission held its second Economic Liberty Task Force roundtable to examine empirical evidence on the effects of occupational licensure. As background, most states have statutory laws, regulation, and administrative rules which establish the scope of practice and conditions for entry into an occupation. This is an issue of importance to CPR since many of our member organizations are governed by state professional licensure boards, and changes to licensing requirements for health care professionals have a direct impact on the health care market as well as patients.
The FTC is focused on this topic because “for some occupations, licensing restrictions
may be an appropriate policy response to protect public safety or satisfy other consumer protection concerns. For other occupations, however, it is questionable whether policy rationales for licensing – and for many of the particular license-related restrictions adopted in some states – are adequate to justify the costs to workers and consumers.” Though this roundtable was focused on occupational licensure across a broad set of industries, CPR has been closely following these discussions because of a recent trend of states seeking to right-size and streamline regulatory oversight of professional licensure by consolidating professional licensing boards. In health care specifically, occupational licensure and board consolidations can impact patient care and oversight of the health care professional field. Because of this CPR believes that it is important to solicit input from key stakeholders in the health care community, including professional licensees, their respective professional associations, and patients/consumers, during the drafting and creation of proposed legislative or regulatory changes related to licensing board consolidation.
Panelists at the FTC roundtable included:
Morris M. Kleiner, Professor of Public Affairs, Humphrey School of Public Affairs, University of Minnesota
Thomas Koch, Economist, Bureau of Economics, Federal Trade Commission Beth Redbird, Assistant Professor of Sociology, Northwestern University
Edward Timmons, Associate Professor of Economics and Director, Center for the Study of Occupational Regulation, Saint Francis University
Jules van Binsbergen, Nippon Life Associate Professor of Finance, The Wharton School, University of Pennsylvania
Abigail Wozniak, Associate Professor, Department of Economics, University of Notre Dame
A number of CPR members were attendance at the meeting. A replay of the roundtable can be watched here.
December 1, 2017
Georgia is currently one of a number of states seeking solutions to closing access to care gaps, especially in rural areas of the state. Specifically, Georgia has 79 counties that have no OB/GYN physicians, 63 counties that have no pediatricians, 31 counties with no internal medicine physicians, and six counties that have no family physicians. As a result, many citizens of Georgia do not have access to these health care services without driving long distances beyond their own counties.
To address this issue, earlier this year the state senate adopted a resolution calling for the formation of a study committee to examine the issue and send recommendations to the legislature. The resolution specifically called for the committee to undertake a review of advanced practice nursing laws and stated that Georgia laws and regulations have not kept pace with the evolution of advanced practice nursing for the past 40 years. The resolution also stated that Georgia is one of only 12 states with laws restricting the autonomy of Advanced Practice Registered Nurses (APRNs).
Among the initial recommendations made by the committee in its final report are for APRNs to be allowed to practice to their full scope and provide more services in Georgia’s rural areas. During the committee meetings, members said the state should be exploring how APRNs could be an important part of the solution for the access to health care “crisis” across Georgia. Members have also called for Georgia to join the national trend of removing legal barriers for APRNs to practice to the full scope of their education, training and certification.
Read the Senate Study Committee’s "Final Report of the Barriers to Georgians’ Access to Adequate Healthcare" here.
FTC Economic Liberty Task Force Holds its Second Roundtable
November 13, 2017