Faith Intro & short excerpts of version AMA Scope of Practice Partnership
This probably should be a part of the AMA series of posts
Introduction and short version, deep dive parts 1,2 3, etc
Faith’s Note:
As you read the following in formation about the AMA’s political activities — all information taken from the AMA’s own publications available on the Internet by googling “AMA SOPP”, that not a word of this has very been part of the news cycle, which is silent as a tomb!
The 30-page AMA report on resolutions passed by their House of Delegates (HOD) for the year 2008 included (along with the SOPP and anti-mfry-PHB / Ricki Lake roast) the following nonsense.
Welcome to the Alice in Wonderland world of organized medicine (and you thought ACOG was the problem!)
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In my research, i ran across these (and other) documents, which i have archived. Enclosed are large excerpts of pertinent parts.
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(1) a resolution declaring that all speciality associations (ex. ACOG, etc) had to get an OK from their state medical association before introducing any legislation that would impact on the scope of practice of any other licensed physicians in their state (obviously doesn’t apply to any of the rest of us!)
resolution 902 ===
Whereas, Our AMA and the Scope of Practice Partnership are uniquely positioned and well qualified to address this matter of extreme urgency so that our state laws and regulations can be upheld and the authority of state medical boards can be re-established as having full jurisdiction, oversight and authority over medical scope-of-practice activities by mid-level practitioners;
therefore be it
RESOLVED, That it shall be the policy of our American Medical Association that state medical boards shall have full authority to regulate the practice of medicine by all persons within a state notwithstanding claims to the contrary by boards of nursing, mid-level practitioners or other entities (New HOD Policy); and be it further
RESOLVED, That our AMA, through the Scope of Practice Partnership, work jointly with state medical boards to assist law enforcement authorities in the prosecution of unlicensed medical practice by limited or mid-level practitioners (Directive to Take Action); and be it further
RESOLVED, That our AMA, through the Scope of Practice Partnership, immediately embark on a campaign to identify and have elected or appointed to state medical boards physicians (MDs or DOs) who are committed to asserting and exercising their full authority to regulate the practice of medicine by all persons within a state notwithstanding efforts by boards of nursing or other entities that seek to unilaterally redefine their scope of practice into areas that are true medical practice. (Directive to Take Action)
Whereas, There is a growing trend of non-physician personnel seeking to expand their scopes of work into functions that traditionally constitute the practice of medicine; and
Whereas, The diagnosis of disease constitutes the practice of medicine and requires the integration of the interpretation of a study or studies with clinical experience and training;
AMA Policy H-35.988 furthers the public interest in quality medical care by opposing enactment of legislation to authorize the independent practice of medicine by any individual who has not completed the state’s requirements for licensure to engage in the practice of medicine and surgery in all of its branches; and
Whereas, AMA Policy H-35.973 supports the formulation of clearer definitions of the scope of practice of physician extenders to include direct appropriate physician supervision and recommended guidelines for physician supervision to ensure quality patient care;
and
Whereas, AMA Policy H-35.993 opposes any legislation or program that would provide for Medicare payments directly to physician extenders, or payment for physician extender services NOT provided under the supervision and direction of a physician; therefore be it
RESOLVED, That it shall be the policy of our AMA that the Medicare physician fee schedule compensate only authorized persons for the diagnostic interpretation of a specific patient and should not provide payments directly to non-physician personnel working under the supervision or in collaboration of a physician to perform a laboratory study or studies (New HOD Policy); and be it further
(3) AMA approved a policy permitting non-physicians to perform intraoperative neuro-physiologic monitoring of anesthetized patients during surgery, which they simultaneously identified as a restricted ‘practice of medicine’ and OK’d to “be delegated to non-physician personnel under direct supervision or online real-time supervision of the operating surgeon or another physician trained in, or who has demonstrated competence, in neurophysiologic techniques and is available to interpret the studies and advise the surgeon during the surgical procedures
Faith’s Note — I assume this is like having L&D nurses sit out at the desk and watch banks of EFM screens
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RELEVANT AMA POLICY
H-35.973 Scopes of Practice of Physician Extenders
Our AMA supports the formulation of clearer definitions of the scope of practice of physician extenders to include direct appropriate physician supervision and recommended guidelines for physician supervision to ensure quality patient care. (Res. 213, A-02)
H-35.988 Independent Practice of Medicine by “Nurse Practitioners”
The AMA, in the public interest, opposes enactment of legislation to authorize the independent practice of medicine by any individual who has not completed the state’s requirements for licensure to engage in the practice of medicine and surgery in all of its branches. (Sub. Res. 53, I-82; Reaffirmed: A-84; Reaffirmed: CLRPD Rep. A, I-92; Reaffirmed: BOT Rep. 28, A-03
H-35.993 Opposition to Direct Medicare Payments for Physician Extenders
Our AMA reaffirms its opposition to any legislation or program which would provide for Medicare payments directly to physician extenders, or payment for physician extender services not provided under the supervision and direction of a physician. (CMS Rep. N, I-77; Reaffirmed: CLRPD Rep. C, A-89; Reaffirmed: Sunset Report, A-00)
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resolution 204 – midwifery scope of practice and licensure
resolution 239 – midwifery scope of practice and licensure
Your Reference Committee heard testimony supporting increased regulation of home deliveries. Proponents provided important testimony discussing the many negative outcomes and mortality associated with inappropriate and/or unregulated home deliveries.
Your Reference Committee heard testimony in support of state legislation that helps ensure safe deliveries and healthy babies. Your Reference Committee therefore recommends adoption of Resolution 205 as amended.
Your Reference Committee heard considerable testimony about regulation and limits on the scope of practice regarding midwives. Your Reference Committee agrees with testimony supporting the need for a regulating body over midwives and believes that AMA resources would best be utilized by supporting state legislation reflecting the same. After hearing the testimony and reviewing the resolution, your Reference Committee recommends adoption of Resolution 204, as amended, in lieu of Resolution 239.
RECOMMENDATION A:
Mr. Speaker, your Reference Committee recommends that the second resolve of Resolution 204 be amended by insertion and deletion on page 2, lines 1-2 to read as follows:
That our American Medical Association develop model legislation support state legislation regarding appropriate physician and regulatory oversight of midwifery practice, under the jurisdiction of either state nursing and/or medical boards.
RECOMMENDATION B:
Mr. Speaker, your Reference Committee recommends that Resolution 204 be adopted as amended in lieu of Resolution 239.
HOD ACTION: Resolution 204 adopted as amended in lieu of Resolution 239.
Resolution 204 asks
(1) that our American Medical Association only advocate in legislative and regulatory arenas for the licensing of midwives who are certified by the American College of Nurse-Midwives;
(2) our AMA develop model legislation regarding appropriate physician and regulatory oversight of midwifery practice, under the jurisdiction of either state nursing or medical boards;
(3) that our AMA continue to monitor state legislative activities regarding the licensure and scope of practice of midwives; and
Faith’s Comments — seems like the AMA’s minions are stocking us, as well as snooping in our underwear drawer
(4) that our AMA work with state medical societies and interested specialty societies to advocate in the interest of safeguarding maternal and neonatal health regarding the licensure and the scope of practice of midwives.
Resolution 239 asks
(1) that our American Medical Association develop model legislation regarding appropriate physician and regulatory oversight of midwifery practice, under the jurisdiction of either state nursing or medical boards;
(2) that our AMA continue to monitor state legislation activities regarding the licensure and scope of practice of midwives and
(3) that our AMA work with state medical societies and interested specialty societies to advocate in the interest of safeguarding maternal and neonatal health regarding the licensure and the scope of practice of midwives.
(2)resolution 205 – home deliveries
RECOMMENDATION A:
Mr. Speaker, your Reference Committee recommends that the second resolve of Resolution 205 be amended by insertion and deletion on lines 24-28 to read as follows:
That our AMA develop model state legislation in {{NOTE the change from “develop” to “support” legislations, a change to reduce the appearance of anti-trust violations support state legislation that helps ensure safe deliveries and healthy babies by acknowledging of the concept that the safest setting for labor, delivery and the immediate post-partum period is in the hospital, or a birthing center within a hospital complex, that meets standards jointly outlined by the AAP and ACOG, or in a freestanding birthing center that meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers.
RECOMMENDATION B:
Mr. Speaker, your Reference Committee recommends that Resolution 205 be adopted as amended.
HOD ACTION: Resolution 205 adopted as amended.
Resolution 205
(1) that our American Medical Association support the recent American College of Obstetricians and Gynecologists (ACOG) statement that
“the safest setting for labor, delivery, and the immediate post-partum period is in the hospital, or a birthing center within a hospital complex, that meets standards jointly outlined by the American Academy of Pediatrics (AAP) and ACOG, or in a freestanding birthing center that meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers”;
and
(2) that our AMA develop model legislation in support of the concept that the safest setting for labor, delivery, and the immediate post-partum period is in the hospital, or a birthing center within a hospital complex, that meets standards jointly outlined by the AAP and ACOG, or in a freestanding birthing center that meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers.”
