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District Branches in the News
Physician Coalition Prepares For Scope-of-Practice Battles
Psychiatric News
Volume 41 Number 3 page 10-10

Oklahoma psychiatrists have helped create a physician coalition to prevent expansions in scope of practice sought by some allied health professionals.

The PatientsFIRST Coalition, which was launched in September 2005, represents more than 7,000 Oklahoma physicians in nine medical specialties in an effort to block legislative expansion of allied health professionals' practice into areas of medical privilege.

"We're going to start educating legislators to the point where they know what is going to be asked of them [by allied health professionals], and when this legislation comes up, it won't just be psychiatrists coming to them but a united front of physicians," said Art Rousseau, M.D., cochair of the coalition.

Rousseau, Public Information/Legislative Committee chair of the Oklahoma Psychiatric Physicians Association (OPPA), said the coalition's goal is to educate legislators about the additional education and training physicians receive beyond what allied health professionals receive, so they know why medical activities, such as prescription of medications, should be entrusted to them. The educational effort is meant to preempt legislation to expand other professionals' scope of practice.

The coalition was spurred by the state legislature's recent approval of some surgical privileges for optometrists. Two years ago a bill was introduced in the state Senate to expand prescription privileges to psychologists, but the legislation never advanced. However, similar legislation was approved in recent years in Louisiana and New Mexico.

"What we're finding is that all of the medical specialties are facing the same issues," Rousseau said, about efforts by some allied health professionals, including pharmacists and nurse practitioners, to expand their legal scope of practice.

The coalition aims to inform legislators that an issue its opponents frame as a turf war and political bullying is in reality critical to patient safety.

Ondria Gleason, M.D., president of the OPPA, said one reason that it is important for individuals with a mental health problem to be seen by psychiatrists is that psychiatrists can recognize when a patient presents with symptoms that might be due to a nonpsychiatric disorder.

"If you don't have appropriate medical training, you would not know the difference between someone who has what appears to be depression but who really has a pituitary abnormality or someone who appears to be psychotic but what they really have is an adverse reaction to a medication," Gleason said.

The coalition is based on medical coalitions in other states, including one in Texas that managed to defeat an optometrist-advocated expansion in scope of practice in 2005.

In addition to the OPPA, the coalition includes the Oklahoma State Medical Association, Oklahoma Osteopathic Association, Oklahoma Academy of Otolaryngology-Head and Neck Surgery, Oklahoma Society of Anesthesiologists, Oklahoma Academy of Ophthalmology, and the Oklahoma chapters of the American College of Physicians, American Academy of Family Physicians, and American College of Obstetricians and Gynecologists.

The coalition, which has already added two member groups since it was launched, hopes to add other medical specialty representatives.

Future efforts may include political fund raising and urging the introduction and passage of its own legislation, Rousseau said. ▪

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