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CHICAGO -- The American Medical Association voted Wednesday to oppose physician assistants having their own regulatory boards, but stopped short of addressing the independence of a group of nurse practitioners -- for now.
Debating at the annual AMA House of Delegates meeting, delegates also supported keeping medical licensing and regulatory boards in charge of regulating "the practice of medicine through oversight of physicians, physician assistants and related medical personnel."
The provision addressing physician assistant boards specifically calls for AMA to "oppose legislative efforts to establish autonomous regulatory boards meant to license, regulate, and discipline physician assistants outside of the existing state medical licensing and regulatory bodies' authority and purview."
The move follows the American Academy of Physician Assistants' in May seeking to remove state ordinances that "require a PA to have and/or report a supervisory, collaborating, or other specific relationship with a physician ... [and seeking to establish] autonomous state boards with a majority of PAs as voting members to license, regulate and discipline PAs, or for PAs to be full voting members of medical boards."
An AMA committee report labeled this an "anticipated legislation to move PAs into a more autonomous role" since state medical boards have authority over PAs at the moment, the committee reported.
AMA delegates also introduced a similar measure to place advanced practice registered nurses (APRNs) under state medical board and regulatory control, with AMA developing model state legislation.
But by a 254-204 vote that measure was referred back to an AMA council for additional study. "Every state places the authority to regulate APRNs under the state nursing board -- a structure that is unlikely to change," according to an AMA committee report.
That vote likely frustrated some delegates who had spoken up during discussion. "This is a timely matter," said a delegate from California. "It has been set up wrong for years and it needs to be changed."
"We can only interview physicians to find out what's going on right now," said John Goldman, MD, a Georgia rheumatologist. APRN's report to nursing boards and "we never get anything back."
Targeting Tobacco
Also Wednesday the House debated, but ultimately declined to rule on, a resolution asking AMA to be more aggressive countering tobacco and nicotine use.
Portions of the measure contradicted AMA policy that favors "FDA-approved smoking cessation tools and prohibits product claims of reduced risk or effectiveness as tobacco cessation tools, until credible evidence is available," according to an AMA committee report. Delegates supported that committee, calling for the the measure to be dropped.
Other delegates successfully lobbied to have the measure studied further instead, pushing for research into cessation strategies and prohibiting marketing of "electronic nicotine delivery system" and tobacco to children. "A lot of people think these harm-reduction techniques are as dangerous as smoking," said James Felsen, MD, of West Virginia. "We need to get that message out (that they are not)."
"There are other ways to talk to patients about this," said Alan Klitzke, MD, of the American College of Nuclear Medicine. "We need to study this."
The measure was referred to an AMA council for further study, by a 299-154 vote (with those opposed seeking to squash it).