States are looking to expand the scope of practice for physician assistants, nurse practitioners, optometrists, and pharmacists to meet the primary care shortage caused by Obamacare.

The Los Angeles times reports that: 

About 350 laws altering what health professionals may do have been enacted nationwide in the last two years, according to the National Conference of State Legislatures. Since Jan. 1, more than 50 additional proposals have been launched in 24 states.

These proposals do not allow non-physicians to completely move into the MD’s domain, which is full authorize to diagnose and treat disease.  Nonetheless, the proposed legislation will allow non-physician practitioners (NPPs) to do more for patients with chronic diseases such as diabetes.

Such scope of practice expansion is opposed by medical groups–for example:

The California Medical Assn. says healthcare professionals should not exceed their training. Phinney, a pediatrician, said physician assistants and other mid-level professionals are best deployed in doctor-led teams. They can perform routine exams and prescribe medications in consultation with physicians on the premises or by teleconference.

The article did not discuss expanded scope of practice for chiropractors, acupuncturists, massage therapists, and other CAM (complementary and alternative medicine) providers, nor did it mention naturopathic physicians (NDs).  Nor were providers such as nutririonists and dietitians mentioned.


The Michael H Cohen Law Group represents healthcare practitioners (such as physicians, nurses, dentists, psychologists, chiropractors, and other clinicians); healthcare facilities (such as hospitals, IDTFs, integrative medicine centers, medical groups, and psychotherapy practices); health-related business (such as manufacturers and distributors of cosmetics, dietary supplements, and medical devices; e-health and telemedicine providers; and medical spas); and entrepreneurs and start-ups on general business legal issues.

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