State Medical Society Just Says No: To Podiatrists, Midwives and Optometrists

The Massachusetts Medical Society was busy today trying to block a slew of health bills that would give certain providers, ranging from naturopaths to nurse midwives and physician assistants, greater authority and scope in their practices. (And thereby, theoretically, diminish the power of physicians).

The Society’s opposition to the nine bills before the Joint Committee on Public Health, “is based on its belief that, should these bills be enacted, diminished patient safety for Massachusetts residents could result,” the organization said in a press release. Here are a few of the legislative proposals they oppose, in their own words:

– House 2367 – An Act to Create a Board of Registration in Naturopathy – Saying that naturopathy is “a hodge-podge of nutritional advice, home remedies, and discredited treatments,” the MMS opposes a bill that would make naturopathic doctors licensed health care providers in the Commonwealth.

–House 1476 and Senate 1145 – Acts Relative to the Registration of Podiatrists – These are identical bills that would extend the scope of practice of podiatry beyond the diagnosis and treatment of the foot to include the ankle and the leg below the knee. The MMS said “this is an unfortunate example of non-physicians seeking to practice medicine without having to undergo the educational and training requirements demanded of all medical doctors or orthopedic surgeons.

–House 2348, House 2357, and House 3163, Acts relative to optometric patient care – These bills would expand the practice of optometrists by allowing them to prescribe oral therapeutic medications. MMS opposes these bills because there is sufficient access to ophthalmologists to treat any eye disease and that optometrists are seeking to expand their business at the expense of their patients.
“Doctors of optometry are not medical doctors” the MMS said, and “optometry is a different profession from the treatment of disease.”

–House 2369 – An Act Relative to Enhancing the Practice of Nurse Midwives – The Medical Society opposes this bill because it repeals the existing legal structure for nurse midwifery as practiced in Massachusetts for decades and “severs the connection between nurse midwives and obstetrician gynecologists and eliminates a requirement to work with a hospital-based team.” The Society said it believes that the existing statutory requirements contribute to our good outcomes, convey a public protection benefit and have no negative impacts whatsoever on patient choice to work with nurse midwives. “If the decision were to be made for the best interest of children,” the Society concluded in its testimony, “the decision would be clearly not to support legislation designed to eliminate or minimize physician participation in obstetrics.”

–House 1520, An Act Encouraging Nurse Practitioners and Physician Assistants of Primary Care and House 1477, An Act to Streamline Health Care Services by Allowing Nurse Practitioners to Verify Medical Papers and Records – The bills seek to eliminate the word “physician” from current state statutes and instead use the term “provider,” raising the issue of the statutory role of physicians in patient care. While it would eliminate the word ‘physician’ from statutes, the bill offers a nebulous definition of primary care provider to the public health laws of the Commonwealth. The bills also strike out the current law requiring that the name of a supervising physician be listed on prescriptions of physician assistants…”

Are there any nurse midwives, podiatrists or physician assistants out there who care to respond? Please…

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