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Fighting for Physician-led Care

Many hospitals are responding to resource constraints and staffing challenges by allowing nonphysicians—like physician assistants or nurse practitioners—to perform complex medical procedures without supervision. 

ACEP believes that an emergency physician should lead every emergency care team in the country. Physician assistants (PAs) and nurse practitioners (NPs) are integral and valued members of the care team. But they do not have the training or expertise of an emergency physician. Regardless of where a patient lives, anyone who goes to the emergency department deserves access to the highest quality care delivered by emergency physician-led teams.

Campaigns

ACEP is making it clear: there is no substitute for a licensed, trained, and board-certified emergency physician. ACEP has launched a campaign to educate patients and policymakers about the importance of physician-led care teams.

"What Happens When The Wrong Person
Is Leading Your Care?"

"Who is an Emergency Physician?"
The Importance of Physician-Led Care

Public Education Campaign: Scope of Practice

ACEP/Morning Consult Poll: Widespread Concern if Physicians Aren’t There to Lead Care (March 2022)

ACEP/Morning Consult Poll: Adults Prefer Physician-Led Care in Crisis (August 2021)

Communication Resources

Sample Op-Ed: Scope of Practice

Social Media Posts: Scope of Practice

Talking Points: Scope of Practice

Partnerships

In 2021, ACEP joined the American Medical Association (AMA) Scope of Practice Partnership (SOPP), a group of more than 100 national, state and specialty medical associations that share the belief that patients deserve care led by physicians. The resources and advocacy of this partnership are frequently deployed in states where troubling scope of practice legislation surfaces.

more AMA Scope of Practice Partnership

Advocacy

ACEP advocates at the state and federal levels for policies that prioritize emergency physician-led teams in the emergency department. We are working to establish commonsense principles for model state legislation and best practices for scope of practice in the emergency department as we fight back against bills that would expand the scope of nonphysicians.

There have been more than 70 bills introduced in state legislatures seeking to expand scope of practice for nonphysician health care professionals across medical specialties and functions, according to the National Conference of State Legislatures.

During the 2021-22 legislative session, emergency physicians worked to defeat HB 354, a bill that would have removed the physician-collaboration requirement for APRNs for prescribing in Kentucky

 


ACEP was part of the coalition that successfully advocated for the governor of Wisconsin to veto SB 394. This bill would have removed physician supervision or collaboration requirements for nurse practitioners, nurse anesthetists and clinical nurse specialists after 3,840 clinical care hours in their APRN role with a physician or dentist. 

 

Emergency physicians in Colorado were instrumental to defeating HB 1184, a bill that would have removed the supervision requirements for physician assistants and required formal collaboration with a physician only for PAs with fewer than 5,760 hours of experience.



In South Dakota, emergency physician advocacy prevented SB 134 from passing in the Senate. 

 

 

And, a strong effort in Louisiana was essential to defeating a bill that would have granted full practice authority to advanced practice registered nurses.

 

 

Education Resources

Webinar: “The Changing Role of PAs and NPs in the ED” (ACEP Democratic Group Section, May 2022)

Workforce Minute - Dr. Gillian Schmitz - Scope of Practice

Workforce Considerations: ACEPs Commitment to You and Emergency Medicine (ACEPNow, April 2021)

YPS Addresses EM Workforce Questions in Webinar

Navigating the Workplace with Advanced Practice Providers

Research

  1. Advanced practice providers proficiency-based model of ultrasound training and practice in the ED (Journal of the American College of Emergency Physicians Open, January 11, 2022 doi.org/10.1002/emp2.12645)
  2. Evaluation of an advanced practice provider emergency department critical care step-down unit (Journal of the American College of Emergency Physicians Open, June 11, 2020 doi.org/10.1002/emp2.12094)
  3. Opioid Prescribing by Primary Care Providers: a Cross-Sectional Analysis of Nurse Practitioner, Physician Assistant, and Physician Prescribing Patterns (General Internal Medicine, September, 2020, 35(9):2584-2592. doi: 10.1007/s11606-020-05823-0. Epub 2020 Apr 24.)
  4. National Trends in the Utilization of Skeletal Radiography From 2003 to 2015 (American College of Radiology, October 15, 2018, (10):1408-1414. doi: 10.1016/j.jacr.2017.10.007. Epub 2018 Mar 23.)
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