ANNA and other health care professional organizations issue statement urging cooperative patient care and opposing Scope of Practice Partnership and AMA Resolution 814

Healthcare Professionals Urge Cooperative Patient Care;

Oppose SOPP & AMA Resolution 814

The undersigned organizations represent a wide variety of more than 3 million healthcare professionals, providing a diverse array of safe, effective and affordable services. We are united in declaring that the Scope of Practice Partnership (SOPP) that various physician[1] organizations have formed, as well as American Medical Association (AMA) Resolution 814, are unnecessary actions that will impede, rather than enhance, patient access to quality care. We call upon the SOPP member organizations to cease their divisive efforts and, instead, work with us to advance the health and well-being of patients. It is inappropriate for physician organizations to advise consumers, legislators, regulators, policy makers or payers regarding the scope of practice of licensed healthcare professionals whose practice is authorized in statutes other than medical practice acts. The erroneous assumption that physician organizations should determine what is best for other licensed healthcare professionals is an outdated line of thinking that does not serve today’s patients.

The SOPP is a coalition that the AMA formed to assist various physician organizations facing scope of practice “battles.” The SOPP also plans to fund studies a) determining whether “allied health professionals” truly fill healthcare voids in rural and other underserved areas; and b) examining the education and training of “allied health professionals” with the goal of providing this information as a “point of comparison” to legislators.

In a related action, at its November 2005 Interim Meeting, the AMA House of Delegates adopted Resolution 814, titled, “Limited Licensure Health Care Provider Training and Certification Standards.” The resolution states:

RESOLVED, That our American Medical Association, along with the Scope of Practice Partnership and interested Federation[2] partners, study the qualifications, education, academic requirements, licensure, certification, independent governance, ethical standards, disciplinary processes, and peer review of the limited licensure health care providers, and limited independent practitioners, as identified by the Scope of Practice Partnership and report back at the 2006 Annual Meeting.[3]

Regarding the SOPP and Resolution 814, we state:

Patient Safety

Our organizations set the highest standards for patient safety, and numerous studies demonstrate that our members provide safe, high quality care. Neither the SOPP nor Resolution 814 cite any credible evidence that the scopes of practice of our members are unsafe, problematic, or warrant special scrutiny or study. To the contrary, our members are filling a vital need in this country. With shortages in various areas of healthcare, and more than 45 million uninsured Americans, our members are the solution to this country’s healthcare challenges, not the problem. Some physician organizations have characterized our efforts to enhance our scopes of practice as a “threat.” Far from that, with America’s population aging, we are the answer to the challenge of keeping pace with the demand for quality healthcare services. Now is the time to encourage the increased use of all available healthcare professionals to meet the growing demand for affordable, high quality care.

Balanced Study

Physician organizations are not in the best or most objective position to conduct a balanced and fair assessment of education and training standards for other licensed healthcare professions. A balanced study of healthcare professions would include an evaluation of physician scope of practice and consider whether physician scope of practice is overbroad. Such a study would also assess whether state laws and regulations governing physician practice contain outdated language that should be eliminated so that the unique skills of licensed healthcare professionals who do not hold a medical license are recognized. The study would also evaluate the implications of current state laws that allow physicians to practice in any specialty, regardless of individual qualifications to do so.

AMA Resolutions Unwarranted/Need for Cooperation Instead

In the past decade, the AMA has adopted at least seven resolutions concerning one or more of the undersigned professions that, if implemented, would restrict our practice and impede patient access to care.The resolutions have been widely ignored. The SOPP appears to signal a renewed effort, buttressed by substantial expenditures, to restrict the practice of healthcare professionals who are not physicians.  It is time for the AMA and other SOPP member organizations to recognize that our members have long demonstrated that they provide high quality, safe care and do not warrant the singular and extraordinary scrutiny that the SOPP and Resolution 814 seem to contemplate. There is more than enough room – and need – for all of us. We need to work together, all of us contributing our respective expertise.  This occurs every day in clinical settings, with the many different types of healthcare professionals who we represent cooperating with primary care physicians and various physician specialists.  Rather than endlessly attempting to keep healthcare professionals who are not physicians from practicing to their full capability, it’s time for SOPP member organizations to join us in advancing a more productive agenda.  The winners will be patients. 

Healthcare Access

It is ironic that the SOPP seeks to study whether healthcare professionals other than physicians “truly” fill healthcare voids in rural and other underserved areas. It has long been amply demonstrated that if it weren’t for healthcare professionals other than physicians, millions of patients in rural and underserved areas would not have access to needed services. The SOPP seems to imply that healthcare professionals other than physicians aren’t necessary unless physicians aren’t available. This ignores the value and effectiveness of our members, regardless of whether an area is urban or rural. We call upon the AMA and other SOPP members to join us in finding solutions to America’s healthcare problems rather than wasting resources to “study” healthcare professionals who are safe and qualified.


Terms such as “allied health practitioner,” “limited licensure health care provider,” or “non-physician” reflect an anachronistic view of healthcare professionals who are not physicians. Our members are not physician adjuncts, and are independently responsible for their actions, regardless of whether physicians are involved.


We ask the SOPP member organizations to cease their divisive efforts, and work with us to improve access to a wide variety of healthcare professionals who deliver affordable, effective healthcare to patients.

[1] The “physician” organizations to whom this document refers are some of those representing medical doctors (MDs) or doctors of osteopathy (DOs).  The term “physician,” as used in this document, does not refer to physicians (such as chiropractors) who are not MDs or DOs.

[2] The “Federation of Medicine” includes the AMA, organizations with voting representation in the AMA’s House of Delegates, and the component societies (e.g., state medical societies) that work with each other to pursue common goals.

[3] The AMA’s Annual Meeting occurred June 10-14, 2006 in Chicago.

Date:  June 1, 2006

Updated:  June 19, 2006

Organizations United In Support of This Statement

Date: June 8, 2006

  1. American Academy of Nurse Practitioners (AANP)
  2. American Association of Colleges of Nursing (AACN - Colleges BSN/Higher Education)
  3. American Association of Nurse Anesthetists (AANA)
  4. American Association of Critical-Care Nurses (AACN - Critical Care)
  5. American Chiropractic Association
  6. American College of Nurse-Midwives (ACNM)
  7. American College of Nurse Practitioners (ACNP)
  8. American Nephrology Nurses’ Association (ANNA)
  9. American Nurses Association (ANA)
  10. American Physical Therapy Association (APTA)
  11. American Psychological Association (APA)
  12. American Psychiatric Nurses Association (APNA)
  13. American Speech-Language Hearing Association (ASHA)
  14. Association of Rehabilitation Nurses (ARN)
  15. Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN)
  16. Emergency Nurses Association (ENA)
  17. National Association of Clinical Nurse Specialists (NACNS)
  18. National Association of Pediatric Nurse Practitioners (NAPNAP)
  19. National League for Nursing (NLN)
  20. National Nursing Centers Consortium (NNCC)
  21. National Organization of Nurse Practitioner Faculties (NONPF)
  22. National Association of Nurse Practitioners in Women's Health (NPWH)
  23. Oncology Nursing Society (ONS)
  24. Preventive Cardiovascular Nurses Association (PCNA)
  25. Wound Ostomy and Continence Nurses Society (WOCN)