Part One ~ AMA brags about its national “60 Victories” (now 75) over 11 healthcare professions in 24 state legislatures

by faithgibson on August 7, 2020

in AMA's SOPP, Economic Issue$

Part 1 of 2, link at the bottom to my posted “My Comments”


Self-serving motives behind the AMA’s 2006 “Scope of Practice Partnership” & its 2020 “Victory Letter” bragging about the success of it’s illegal monopoly

 

Anti-trust, anti-monopoly laws

In 2006, the AMA’s House of Delegates passed a flurry of “resolutions” pejoratively defining non-MD practitioners as “physician extenders“. 

At that time, the House of Delegates identified ten specific categories of indepently practicing professional healthcare providers that included:  

Nurse Practitioners, Nurse-anesthetists, nurse- midwives, Naturopaths, Optometrists, Physician-assistants, Psychologists, Pharmacists,
Physical therapists, and Podiatrists

The AMA’s new category “physician extender” made it illegal for them to directly provide the form of healthcare that they’d gone to school for several years and paid many thousands of dollars to become professionally trained and licensed.

For example, it would be an “illegal practice of medicine” for a nurse-practitioner, physical therapist, or podiatrist to examine you, take your vital signs (BP and temperature, etc) record your health history, or provide a healthcare service such as a paps smear or a flu shot.

As gleefully reported in the AMA’s 2020 “Victory Letter” this medical cabal had successfully convinced (via a very generous campaign contribution to every in each of these state legislators!) to strip the right to independently practice to  75-plus scope of practice victories in 21 states by 2020

Over the last two years, the AMA secured over 75 state legislative victories stopping what they described as “inappropriate scope expansions of non-physicians”.
This work was done in strong collaboration with state medical and national specialty societies, including:
  • Nurse Practitioners & independent practice (AR, CA, IL, IN, LA, MS, MT, NJ, OH, TN)
  • Nurse-anesthetists & opt-out of Medicare supervision (CO, MS)
  • Nurse-anesthetists & independent practice (AR, IL, MS)
  • Nurse-midwives & independent practice (NE)
  • Physician assistants & independent practice (IL, LA, ME, MT, NV, OR)
  • Psychologists & independent prescribing of psychotropic medications (CT, FL, HI, IL, MT, NE, VT)
  • Optometrists & surgery (MD, MS, NE, ND, VT)
  • Pharmacists & prescribing (AZ, IA, IL, IN, VT)
  • Naturopaths & licensure (CT, IL, MD, OR)
  • Physical therapists & direct access (AL_
  • Podiatrist & surgery of lower leg (ME)

This means the AMA and it’s 105 “Scoop of Practice Partners” was able to convince the elected legislators from the following 21 states — AL, AR, AZ, CA, CT, FL, HI, IL, IN, LA, MD, ME, MS, MT, NE, NJ, NV, OH, OR, TN, VT to join the AMA’s monopoly that not only imposes their quasi-criminal monopoly over ten categories of professional healthcare practitioners but dramatically increase the cost of health care which always mean the people who otherwise would have been able to get necessary and effective healthcare service will instead suffer needlessly and many will die unnecessarily or prematurely.

Having now gutted  profession allowed the AMA to do several things that were very favorable to MDs while being extremely detrimental to independent practitioners and the public. These new and legally =-restrictive definitions of non-MD practitioners provide great economic advantages to MDs while dramatically increasing the cost of healthcare and the number of Americans who would be unable to afford medical care.

Unfortunately, their self-serving “victories” not only were harmful to the 75 different healthcare professionals in 21 states but that kind of harm is “the gift that keeps on giving” or in this instance, harming Americans of all ages.

If I were to type the words “Shame on you!” a hundred thousand times, it would not account for all of the harm the AMA has wrecked on the American public so they could continue to perpetrate what certainly appears to be an illegal monopoly, while also stroking the egos of MD who apparently must be able to Lord it over non-MD practitioners in feel satisfied with their own life!   

AMA’s Scam of the 21st Century: House of Delegates resolution 160.949 – Practicing Medicine by Non-Physicians

All of the craziness and harm to both practitioners and patients that is described above was predicated on claims by the AMA’s House of Delegates that the independent practice of non-MD practitioners:

“…. alters the traditional pattern of practice in which the physician directs and supervises the care given;

House of Delegates resolution 160.949 – Practicing Medicine by Non-Physicians

At least as defined by the AMA, allopathic medical doctors (MDs) are at the top of a power pyramid, able to exercise total control over all facets of the American medical/healthcare system.

In this dystopian system, MDs make all the decisions decide what category of a non-MD healthcare provider is allowed to do, and be sure that all the money first flows to doctors, who in turn disperse it to the AMA to use as they sees fit. 

This is a system that perpetuates the role of the AMA as absolute gatekeepers and arbitrators of the American healthcare system. Since the creation of the AMA in first

These AMA Resolutions start by claiming that the independent practice of all non-MD professionals was an illegitimate (i.e. illegal) practice of medicine.

(4) continues to encourage state medical societies to oppose state legislation allowing non-physician groups to engage in the practice of medicine without physician (MD, DO) training or appropriate physician (MD, DO) supervision;

House of Delegates resolution 160.949 – Practicing Medicine by Non-Physicians

As defined by AMA House of Delegates’ resolutions, non-MD practitioners would only be allowed to provide the services they were formally educated and licensed to provide by being hired to work as employees in a doctor’s office or clinic. 

In addition, these AMA House of Delegates resolutions called passage for of laws making it illegal for these practitioners to be directly reimbursed by insurance companies and the federal MediCare – MediCaid programs.

This describes a system in which MDs hire non-MD practitioners to provide medical services and then the employer-MD bills the insurance company and federal Medicare-Medicaid program, which reimburses the doctor instead of the practitioner that actually provided the services.

Meanwhile, the non-MD practitioner, who is providing this specialized care is being paid a yearly salary or hourly wage.   

As defined by the AMA, these laws would give the allopathic medical profession a virtual monopoly over all medical services in the US. 

Under the Trump administration, this concept was successfully carried out as state chapters of the AMA convinced the legislators of 21 states to pass laws making the independent practice of these professionally educated non-MD practitioners illegal, thus forcing formally independent practitioners to become the employees of MDs at the same time their MD-employers were billing third-party payors for services provided by them.  

Conclusion:

The Problem: In 2006 the American Medical Association (AMA) created the Scope of Practice Partnership (SOOP). This is an ‘in-house (within the AMA’s system of “House of Delegates”) that is a coalition of 105 other allopathic medical lobbies representing the professional and economic interests of MDs.

These self-interested organizations banded together to use the legendary political influence and economic assistance of the AMA (“More than $2 million in grants awarded — see the organization’s online “Victory Letter” below) to make it illegal for non-MD practitioners to practice as independent providers and force them to become employees in a doctor’s office.

The Solution: Americans need to know about this travesty and take effective action to repeal this monopolist law. The dozen or so professional organizations that represent different types of independently practicing non-MD practitioners (see list below) can and should form a coalition and fight back using their combined resources to inform the public of what can only be described as a shocking abuse of power by organized medicine.


Words of Doctor Ziegler, MD; 1922  p. 412-413

“The doctor must be enabled to get his money from small fees received from a much larger number of patients cared for under time-saving and strength-conserving conditions;

… he must do his work at the minimum expense to himself, and he must not be asked to do any work for which he is not paid the stipulated fee. This means … doctors must be relieved of all work that can be done by others  —  nurses, social workers, and midwives.” [1922-A; ZieglerMD, p. 412]

“The nurses should be trained to do all the antepartum and postpartum work, from both the doctors’ and nurses’ standpoint, with the doctors always available as consultants when things go wrong; 

….. and the midwives should be trained to do the work of the so called “practical nurses,” acting as assistants to the regular nurses and under their immediate direction and supervision, and to act as assistant-attendants upon women in labor—conducting the labor during the waiting period or until the doctor arrives, and assisting him (not the mother!) during the delivery.” [1922-A; ZieglerMD

“In this plan the work of the doctors would be limited to the delivery of patients, consulting with the nurses, and to the making of complete physical and obstetrical examinations …  [1922-A; ZieglerMD, p. 413]


  • Note-2-self for follow-up material:
    MBC Oct 05, 1993 Del Junco’s task force on state access healthcare
  • Ololade’s Hx of the AMA
  • The Impossible Journey of Abrham Flexner – 2008
  • Story of how nurse-midwives were eliminated from virtually all American hospitals

How babies got born before the AMA and Americal College of Obstetricans claimed to control everything even remotely conected to heatlhcare, including normal chilbirth in healthy women

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