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Coalition forms
in response to AMA action
(August/September
2006 Issue)
By Phyllis Hanlon
Earlier this year, the American Medical Association announced the
formation of the Scope of Practice Partnership (SOPP), a committee
dedicated to actively resisting practice expansion for non-physician
groups. Citing patient safety as a concern, the SOPP plans to conduct
research that examines education and training requirements for allied
health professionals and use that information to influence legislators
as they consider approval of greater practice responsibilities for
these entities.
In response to this action, more than three million allied healthcare
professionals, including psychologists, several nurse specialists,
physical therapists, chiropractors and audiologists from 25 organizations
joined to create the Coalition for Patients' Rights (CPR).
On June 8, the Coalition released a statement asking the SOPP to
terminate its actions and to work collaboratively to provide a safe
and healthy environment for patients. In addition, key members of
the Coalition sponsored a teleconference in which they discussed
the group, its future plans, the AMA's current efforts and the impact
its actions will have on patients.
Russ Newman, Ph.D., J.D., executive director for the American Psychological
Association's Professional Practice, says that the time, money and
resources invested in this recent AMA action surprised psychologists.
The SOPP consists of 12 founding partners with an eye toward eventually
including all 50 state medical associations. Each member has contributed
$25,000 to fund its legislative efforts to limit practice expansion.
Newman says that allied health professionals, particularly in rural
locations, provide several benefits to patients. Specifically, he
cites the advantages of prescribing privileges for psychologists.
"There have been more than 10,000 prescriptions written without
incident. This has helped increase access to mental health services,"
he says.
Additionally, Newman reports that in urban settings, patients
must wait a significant amount of time to see an appropriate medical
professional. The Tennessee Psychological Association reveals a
four-week wait for urbanites while rural residents cannot obtain
an appointment for anywhere from seven and a half to 12 weeks.
According to Newman, this is not the first time psychologists have
faced opposition from other medical professional groups. In the
60s and 70s, psychiatry opposed psychologists' intervention. In
the 80s, Medicare resisted reimbursement for psychological services
and recent efforts to acquire prescriptive powers have been challenged.
Newman says that the Union of American Physicians and Dentists in
California attempted to block psychologists from practicing at state
hospitals, even though in 1990 the Supreme Court supported full
privileges for psychologists at private and state hospitals.
"Medicine should provide interdisciplinary, collaborative care,"
says Newman. "All health care professionals should work together,
not against each other." The formation of this coalition represents
the first cooperative effort to take a stance against the AMA's
actions. Past outreach efforts only involved individual groups.
The Coalition has not yet created a budget and does not plan to
pursue legislation. "The key purpose of CPR is to send the message
that AMA's tactics are not in the interest of patients," says Rose
Gonzales, RN, director of the American Nurses Association. "It would
be better to work together to serve patients' interests."
Mitchell Tobin, J.D., senior director of professional practice
affairs for the American Association of Nurse Anesthetists, says,
"The AMA's declaring war on providers who are not physicians is,
in essence, declaring war on patients." With 45 million uninsured
Americans and an aging population, healthcare demands will increase
in the coming years. "It's outrageous to restrict access," Tobin
says.
Newman says, "The next step is to engage in dialogue with the AMA.
They have been unwilling to meet individually. Maybe meeting collectively
will be better." He adds that if the specter of the AMA's efforts
continues, the Coalition will ratchet up its campaign to "get out
the word." He says, "There is no appropriate evidence for questioning
the credentials, quality and training of our professionals."
Elena Eisman, Ed.D., executive director of the Massachusetts Psychological
Association, says, "At this point, we are informed and supportive
of the APA's efforts." She believes the AMA has taken a "short-sighted
stand" on this issue and that the coalition is one way to counter
their steps. "The whole issue of who can do what is a moving target.
Health care is a challenging profession today," she says. According
to Eisman, the AMA's lobbying efforts to block legislation may affect
access and cost of service for patients.
In response to the Coalition's joint statement and public announcement
of its formation, the AMA's media relations office released a statement
saying that "…in order for patients to receive optimal quality care,
their health care professionals must have the clinical education
and training to provide the service they perform." The statement
emphasizes the 11 to 15 year educational process a physician must
undergo. "This in-depth medical training provides physicians with
the ability to properly diagnose and treat patients based on their
individual needs."
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