Part 3 of 4 ~ Background info on my criticism of the AMA and its “Scope of Practice Partnership” (SOPP)

by faithgibson on May 27, 2023

in Post Roe World, Women's Reproductive Rights

Part 3

The AMA’s Scope of Practice Partnership is a legally sophisticated way to swindle patients and cheat their non-MD healthcare providers and taxpayers at both state and federal level

Who rules the world?
White men in blue suits and black judicial robes
who control who gets to talk into the microphone!

I’ve been both a student of, and very critical of, the AMA for a very long time. If you study the history of the AMA, you will know that its politics is a very “mixed bag”.

For very good reasons, this website ( includes several outspoken posts that object to the AMA sponsoring and continuing to financially support the “Scope of Practice Partnership“, beginning in 2006 and getting bolder and more outrageous by the minute!

The one and only purpose the SOPP is to get new laws passed in all 50 states that would stipe the right to practice for the 12 categories of independently healthcare practitioners listed below, and reduce them to the dependent status of a “physician extender” that can ONLY practice their profession if they are hired to work in a doctor’s office as his or her employee.

This scheme not only dramatically reduces the income and independence of these advanced healthcare practitioners, but the care patients receive from these non-MD practitioners will be billed to insurance companies and federal Medicare or Medicaid programs at the higher rate of an MD.  The doctor’s office will be reimbursed a higher rate than the system would have reimbursed the same care by the same non-MD practitioner. However, this “extra” reimbursement will be pocketed by the MD, who will received income he or she didn’t earn except for having gamed the system.

But that additional income goes directly to the MD-employer for care the he or she did NOT provide. Every time this occurs, every person who pays health insurances premiums and federal taxes is being directly cheated, as we all pay a higher premiums for health insurance and higher taxes to reimburse the cost of care as provide by federal programs such as Medicare order to compensate MD at a higher level for work they did NOT do but was instead done by their advanced practitioner.

As defined by the AMA-SOPP, these 12 categories of advanced practitioners, pejoratively referred to by the AMA as “physician extenders, include physician-assistants, psychologists, pharmacists, physical therapists, podiatrists, all types of nurse practitioners, nurse-anesthetists, nurse-midwives, naturopaths, and optometrists.

The SOPP is a coalition organized by the AMA and financially supported by and beholding to the AMA. As an incorporated coalition, the SOPP consists of the political lobbies of over 100 high-paying specialities  such as anesthesiologists, Ob-Gyns, orthopedists, psychiatrists, etc. Each of these professional lobbies are gifted every year with very large amount by AMA, so they can independently lobby their state legislature.

From AMA’s online “Victory Letter” 

Today, the SOPP is comprised of 105 national, state and specialty medical associations. The SOPP has awarded more than $2 million in grants to its members to fund advocacy tools and campaigns.

Click link below for “big picture” info the AMA’s funding of the SOPP:

  1. More than $3.5 million in grants awarded

The SOPP’s goal is to eliminate the ability of formally educated and licensed healthcare practitioners identified above to provide any legal form of healthcare unless they are the employee of an MD and functioning under his or her orders — a category described by doctors as a “physician extender“.

Personally I think of this as having an “office wife” who does the grunt work, while the doctor does the “important stuff”.

Just since 2019, the political money and lobbying efforts of the Scope of Practice Partnership was able to get sixty (60) new state laws passed in more than a dozens states making it illegal for these healthcare professionals to provide patient care unless they first are hired as an employee of a medical doctor.

If no doctors in their geographical area will hire them, the new SOPP laws legally bar them from practicing their profession — no doctor-employer, no work! Many years of their life, and many thousands of dollars to study for an ‘advanced degree’ is just went down the drain!

While SOPP advocates say this is just a common sense “patient safety” measure, in reality it is as a form of ‘pimping‘, in which professional non-MD employees provide the actual patient care, and then the doctor’s office bills the insurance companies or federal Medicare-Medicaid program in the doctor’s name, and so the DOCTOR gets reimbursed at the higher “MD rate” for care that was actually provided by his employee-practitioners.

In any other field of commerce, this subterfuge would be blatantly illegal.

What this means for the paying public

As persons in need of healthcare, we no longer can make an appointment with our favorite nurse-practitioner, the one we have a relationship with because s/he takes the time to talks to us and spends more time with us than our very busy GP. Being seen by a nurse practitioner also costs less than a formal doctor’s office visit.

Under the circumstances brought about by the SOPP, we now have to make and pay for a doctor’s office visit in order to be seen by our nurse-practitioner. We, or our insurance company, will be billed at the higher rate for an MD visit, even though we were not seen and treated by the doctor.

However, a part of this economic fleasing  is a little charade in which the doctor stick his or her head in the door and ask “do you have any questions?” This fulfills the technicality of doctors bill for having “seen” the patient, even though all the care was provided by the nurse practitioner who was quite literally functioning in place of the doctor, hence the term “physician extender”.

Why is this happening?
Political Background of the AMA-SOPP

I believe the SOPP is part of the (so-far) legal monopoly of allopathic medicine in the United States. In regard to the motives of the SOPP to a way to  and regressive concept that harkens back to 1910 and the bad-old-days of the Flexner Report, which is when MDs got officially elevated to demi-god status. Being a MD was not just a laudable educational attainment, but was assumed to have also deferred the privileges of upper class social status and the political power that came with it.

These was a widespread assumption by MDs, as well a the “lay public”, that medical doctors were uniquely smarter than all the rest of us. As a result they, and they alone, should make the rules that controlled the licensing of healthcare professionals, as well as how and by whom those services should be provided.

The following quote was written by obstetricians, but the 1911 concept of being its own “final authority” applied to all branches of allopathic medicine:

“We believe it to be the duty and privilege of the obstetricians of our country to safeguard the mother and child … The obstetricians are the final authority to set the standard and lead the way to safety.

They alone can properly educate the medical profession, the legislators and the public“. {ref: The Boston Medical and Surgical Journal, 1911, pages 251-261}

The modern scheme cooked up by the SOPP continue to embodies these 1911 ideas of MDs as the very tip-top of the human pyramid, with powers to control and define the practice that even exceed even that of the US Supreme Court. The only person who can determine if the medial treatment provided by an MD was a “competent” or “incompetent” in a court of law is another MD because not even the Chief Justice of the US Supreme Court can “out guess” a medical doctor, unless that judge or justice has a degree as a Doctor of Medicine.

The legislative activities of the SOPP does absolutely nothing to improve our national healthcare system, since its goal is to create and perpetuate an illegal monopoly that increases the income of doctors by having them get paid for work done by others. This is a corrupt practice. Were the AMA-SOPP scheme to succeed, it would disrupt our entire healthcare system, putting the SOPP in the unenviable position of being the dog that caught the car! Be careful what you wish for!

It only fuels the anger and frustration of thousands of highly educated and competent healthcare practitioners (see list below) and drive up the cost of healthcare. Since 2006, the deadly duo of AMA political connections and money funnelled through member organizations of SOPP has been aggressively lobbying (and contributing to) state legislatures.

Remember the AMA’s Scope of Practice Partnership scheme next time you vote.

Make sure your candidate is not taking campaign contributions from the AMA, either at the national or from one of its 50 state chapters.

State chapters of the AMA all have innocuous-sounding names that just puts the state’s name in front of the word “medical association“.

For example, the state chapter of the AMA in my state is called “the” California Medical Association“. Several CMA lobbyists attend every single meeting of the Medical Board of California. They give large campaign donations to the governor’s race and elections of individual assembly members and state senators. Recently, they gave 6 million dollars to the state ‘s democratic party and now no state legislator is will to carry a bill without the prior approval of the state chapter of the AMA.

This same “smoke and mirrors’ charade is true for all the chapter of the AMA in the other 49 US states, as well as the same kind of “regulatory capture” by state-national coalitions of the AMA occurs in all 50 states.

Continued to Part 4 (of 4) An unconscionable genders war against the female gender



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