Bills to expand nonphysicians’ scope of practice ‘rampant’ across US, American College of Radiology says

Bills to expand nonphysician providers’ scope of practice are “rampant” in state legislatures, including one that was recently defeated in South Dakota, the American College of Radiology said Friday.

ACR and the local radiological society helped quash the Mount Rushmore State measure, which would have allowed experienced physician assistants to take X-rays and perform radiologic procedures autonomously. The college labeled the legislation as “dangerous” and “harmful,” urging South Dakota lawmakers to block its passage.

“The [South Dakota Radiological Society] and ACR value the commitment of physician assistants to the team-based model of care and greatly respect the contributions physician assistants make to the healthcare team,” the two organizations wrote last month to the head of the state’s Senate Committee on Health and Human Services. “However, we do not believe their education and training prepare them to independently oversee patient care. The SRDS and ACR are deeply concerned that [Senate Bill] 175 eliminates physician-led teams.”

Following pressure from radiology and other specialties, the bill failed to pass in the South Dakota Senate, ACR said in a March 2 news update. However, similar measures are in the works elsewhere.

Lawmakers in Iowa, for one, have introduced a bill that would repeal the state requirement that physician assistants must practice under a licensed medical doctor’s supervision. ACR sent a letter to a key lawmaker in the Hawkeye State in January, opposing a proposal that would allow physical therapists to order diagnostic imaging. The college pointed to a JAMA Internal Medicine study showing that nonphysicians order more imaging exams than docs following outpatient encounters.

“The findings suggest that expanding the authority to order imaging to nonphysicians has resulted in increased imaging and may have ramifications on care and overall costs,” ACR CEO William T. Thorwarth Jr., MD, wrote. “While we share the concerns for patients to be able to receive care they need, we believe this measure may further elevate healthcare costs and potentially increase unnecessary radiation exposure.”

ACR has made fighting scope creep a key advocacy issue, launching a webpage on the topic and establishing a fund to help radiologists lobby against such bills in their states. Other recent letter writing campaigns have targeted lawmakers in Louisiana, Utah and Wyoming.

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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