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