Physicians have raised concerns that the physician-led team model of care is being undermined by the Federal Trade Commission (FTC) through its recent aggressive advocacy on behalf of the independent practice of nonphysician health care professionals, such as nurse practitioners. The American Medical Association (AMA) has been working to protect patient safety by ensuring that the role of states and medical licensing boards to define appropriate medical standards at the state level is not undermined by federal overreach. Since 2010, the FTC has sent letters to medical boards and state legislatures in nine states—most recently Connecticut and Illinois—in support of bills to remove the collaborative practice agreement for prescriptive authority, and in opposition to bills that would restrict non-physician performance of interventional chronic pain management procedures. In these letters, the FTC relies on “available empirical evidence” to claim that APRN-delivered care settings is at least equivalent to that of physician-delivered care as regards safety and quality.
The AMA assisted the states to address the FTC’s letters. The AMA has also met directly with FTC commissioners to share its position that the FTC does not have the clinical expertise to make judgments regarding the competency of health care professionals to perform medical procedures. The AMA urged the FTC to reexamine their ability to advocate on the complex medical issues involved in state scope of practice activities and medical licensure.
The AMA’s advocacy is paying off. Recent FTC letters no longer include misleading clinical judgments. Disclaimers have been added stating that “FTC staff are not experts in patient care or safety,” and do not offer advice on such matters. For the first time in its letters, the FTC also acknowledged that “certain professional licensure requirements are necessary to protect patients,” and that special practice requirements may be recommended for treatments that present heightened consumer risks. The FTC has also agreed to reach out to medical associations before drafting their letters in the future.
While FTC engagement and court cases are necessary, The AMA’s primary goal is to foster collaboration and coordination among health care professionals to create positive health outcomes for patients. To that end, a recent Virginia law shows a way forward. The Medical Society of Virginia and the Virginia Council of Nurse Practitioners worked together, at the behest of the Virginia General Assembly, to develop legislation on team-based care. The new law calls for nurse practitioners to consult and collaborate with physicians, while defining the physician as the leader of the health care team. The AMA supports the legislation, and believes it can serve as a model for other states as health care professionals work together in a physician-led team to help patients.
The AMA is advocating on your behalf, if you are not a member, consider joining at www.ama-assn.org/go/join