Approximately 140 scope of practice bills were introduced in the Texas Legislature during the last session. None of these bills would have expanded the scope of practice of non-physicians into law, which was considered a major win for both the American Medical Association (AMA) and the Texas Medical Association.
“The threat of scope creep has never been greater in Texas,” AMA member G. Ray Karas, MD, a Beaumont anesthesiologist and president of the Texas Medical Association (TMA), said in an episode of the AMA Update podcast about preventing scope creep in medicine.
When Karras took over the helm of TMA in May, he said one of his top goals was to maintain TMA’s track record of preventing scope of practice encroachments in the Texas Legislature. TMA’s efforts have helped block more than 130 scope of practice expansion bills during the 2023 legislative session. He attributes this success to the strong leadership and relationships TMA has built with state leadership over decades.
Preventing scope creep has also been a key pillar of the AMA’s advocacy efforts to prevent physician-level decisions from being made by less-qualified clinicians who leave medical school to undergo the rigorous training that physicians must undergo. But as the physician shortage worsens, bills at the state and federal levels to expand the practice rights of non-physicians are on the rise as a solution. But the AMA maintains that expanded scope of practice should not give less-qualified clinicians medical leadership and clinical decision-making power, which physicians should continue to have.
“People from all walks of life are trying to become doctors without actually having a license,” Karas said in an interview with AMA Update.
That includes efforts to expand the scope of practice for advanced practice nurses, physician assistants, chiropractors, optometrists, dentists and pharmacists. Karas said he wants to see people without medical training opening medical spas, starting infusion clinics or even performing surgeries.
