AMA Legislative Efforts Spotlight Nonphysician Scope of Practice

Jeremy Lazarus, M.D., chair of APA’s Council on Advocacy and Public Policy, was a featured speaker at a roundtable discussion on nonphysician scope-of-practice legislative initiatives, which was held in January at the AMA State Legislative Conference in Tucson, Ariz.

His presentation was a result of APA efforts at recent national AMA meetings to secure and solidify support from state medical societies and their members concerning issues related to scope of practice. Michael Maves,M.D., AMA’s CEO and executive vice president, chaired the session.

Lazarus told Psychiatric News that the discussion, which was attended by more than 200 people, indicated the “increased prominence” of scope-of-practice issues within the AMA. In December 2002, for example, a New York bill became law that prohibited psychologists and other mental health professionals from prescribing or administering drugs as treatment, therapy, or professional services.

Seth Stein, J.D., the executive director of the New York State Psychiatric Association, told Psychiatric News that the support of the Medical Society of the State of New York was critical to the legislative effort (Psychiatric News, January 17).

In addition to psychiatrists, scope-of-practice issues affect such medical specialists as anesthesiologists and ophthalmologists.

Lazarus told the attendees that APA and its district branches had been involved in fighting legislative battles concerning scope-of-practice issues for more than 20 years.

He said, “The key issue is maintaining quality of care. Weekend courses and other short-term training programs are woefully inadequate forms of preparation for anyone to prescribe medications.”

Lazarus also emphasized the importance of finding solutions for geographic areas in which psychiatrists are in short supply. “For example, we can become involved in training general practitioners in rural areas,” he said.

Through its Council on Advocacy and Public Policy, APA paid the expenses to the meeting for six presidents of district branches from states where scope-of-practice issues are emerging. They are Nevada, Vermont, Tennessee, Oklahoma, Arizona, and Utah.

Mark Suhany, M.D., president of the Nevada Psychiatric Association, told Psychiatric News that his attendance offered several benefits.

“I was able to sit down with the executive director of Nevada’s state medical society for a long discussion about issues related to psychologist-prescribing legislation, if it were introduced in our state. He assured me that his organization would not enter into negotiations about such legislation without representation from psychiatrists, and he later agreed to speak at one of our meetings.”

Suhany said that although no psychologist-prescribing bill had been introduced, he anticipated the introduction of a bill to allow psychologists to admit and discharge patients from hospitals.

He added that he appreciated the opportunity to meet with the other district branch presidents and to learn of the AMA’s interest in scope-of-practice issues. “I realized that we weren’t in the battle alone,” he said.

Staff of APA’s Division of Government Relations who attended the meeting encouraged Suhany and other presidents to form coalitions and alliances.

Suhany said, “When I returned home, I contacted the president of the state NAMI [National Alliance for the Mentally Ill]. We are working with NAMI to promote the state’s mental health budget and to support the building of a public psychiatric hospital in Las Vegas.”

He noted that APA had provided financial support to hire a lobbyist for NPA, who has been effective in working on several issues. ▪