States step in to define scope of practice

In response to the trend of more doctors performing procedures outside their specialty, a number of state legislatures are looking to reexamine the rules surrounding what physicians can and can't do, USA Today reported.

For example, should OB/GYNs perform cosmetic surgery? Are optometrists qualified to do cataract surgery? Should chiropractors be allowed to clear young athletes to return to the field after concussions? These are just some of the questions on the table nationwide. At least 10 bills in Florida alone currently involve such scope-of-practice issues.

"As insurance reimbursements go down and physicians' overhead goes up, they're trying to find new ways to meet their economic needs," Florida state Sen. Eleanor Sobel, a Democrat who is vice chair of the Senate Health Regulations panel, told the newspaper. "But they're not necessarily qualified to do what they're doing."

Meanwhile, some proposals support physicians' prerogative to expand their services. A measure reintroduced in the New York state legislature, for example, would allow dentists trained as oral surgeons to perform cosmetic surgery.

In addition to physicians' qualifications, states also are scrutinizing the safety of the facilities where the surgeries are performed. In Iowa and New Jersey, lawmakers are considering whether outpatient surgery facilities should have to be licensed and accredited like hospitals. Such a requirement, currently in place in 20 states, would help ensure that facilities have proper emergency equipment and that doctors are trained properly to perform the procedures. Some physicians argue, however, that the cost of accreditation would force them to restrict care for needy patients.

To learn more:
- read the article in USA Today