Pushback to the AMA Scope Creep Campaign

In a strongly-worded letter, the American Academy of Physician Associates (formerly Assistants) (AAPA) urges “collaboration rather than competition” and that the American Medical Association (AMA) back off of its long-standing scope creep campaign. In this campaign, the AMA has strategically coordinated efforts to challenge the legislative efforts of nonphysician providers to expand their scope of practice. This campaign is one component of the AMA’s Recovery Plan for America’s Physicians. The AAPA describes the campaign as “spreading misinformation and using fear-mongering tactics” rather than in the best interest of patients.

The AMA campaign identifies particular challengers to the physician-led, team-based care model. In March 2024, AMA News featured an article reporting on the nonphysician groups to watch: Nurse practitioners, other advanced practice registered nurses, and physician associates (PAs) pursuing bills to allow them to practice without physician involvement. The article also highlighted areas that nonphysicians are looking to gain ground with including pharmacist bills to allow testing and prescribing for certain conditions, optometrist bills to perform surgery, and psychologist bills for prescriptive authority. The article also notes that AMA survey data shows that scope of practice is the top legislative priority for 2024 at state medical associations and national medical specialty societies. 

The AMA has identified particular concerns with the efforts to weaken physician oversight of physician associates. Additionally, the AMA does not support the use of the term “physician associate” and continues to use “physician assistant,” despite the AAPA name change in 2021. The AAPA contends that the AMA has made misleading and damaging claims about PAs and cites malpractice data that disputes the AMA’s argument that permissive practice environments are more harmful to patients.

The AMA boasts that it worked with state associations to defeat over 100 state-level scope creep bills in 2023. The AAPA has countered with the charge of AMA being obstructive to expanding access to care. In its letter, the AAPA writes that the campaign is “a thinly veiled effort to maintain outdated practices, rather than confronting the urgent issues we face today.” In February 2024, pharmacist associations also fired back at the AMA over its negative messaging, and called the AMA “out of touch.”

While audiologists are not named specifically by the AMA as a group to watch currently, any efforts for a scope of practice expansion could catch the attention of the campaign and/or the state medical groups. Successful legislation in some states over the last year may inspire an increase in activity, and coordinated efforts between state and national audiology groups may be helpful to counter any challenges from the scope creep campaign.