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CMA objects to federal scope expansion under president’s executive order

October 14, 2019
Area(s) of Interest: Scope of Practice 


President Trump recently signed an executive order with sweeping implications for Medicare, touting it as an alternative to “Medicare for All” proposals.

Although the order is very broad and lacks details, it is clear that the administration is looking at eliminating regulations that require physician oversight of nurse practitioners and physician assistants. The California Medical Association (CMA) opposes any attempts to remove physician oversight over allied health professionals and believes that doing so would put the health and safety of patients at risk. 

 “Since Day One, this administration has worked to undermine access to care and quality of care for patients,” said CMA President David H. Aizuss, M.D. “The president’s latest executive order suggests changes regarding scope of practice that would also have disastrous effects for patients.”

CMA strongly believes that simply expanding the scope of practice of allied health practitioners to give them independent and/or expanded practice will do nothing to improve access to care or quality of care. Allowing practitioners to perform procedures they aren’t trained to do can only lead to unpredictable outcomes, higher costs and greater fragmentation of care.

While an important part of the health care team, nurse practitioners and physician assistants simply do not have adequate training or education to be qualified to practice medicine without physician oversight.

 “We agree that medical professionals should be able to practice at the top of their license, but care must be supervised by a physician who is highly trained and ultimately responsible,” said Dr. Aizuss. “We must ensure that every American, regardless of age or economic status, has access to a trained physician who can provide the highest level of care. Expanding access to care should not come at the expense of patient safety and we will not support unequal standards of care for patients from different economic backgrounds.”

Any proposed regulation must go through the federal rulemaking process. CMA will be closely following this issue and will provide additional details when they become available.

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