What’s the news: Physicians are encouraging congressional leaders to “protect the health and safety” of patients by opposing legislation that would inappropriately allow pharmacists to test and treat patients for certain illnesses.
“Misdiagnoses, siloed and uncoordinated care, and patients not receiving the right care at the right time all lead to worse patient outcomes and add costs to our health care system,” says the letter (PDF) from the AMA and nearly 100 state medical associations and national specialty societies regarding the legislation (H.R. 1770; S. 2477). “We should respect the success of coordinated team-based care and put patient safety first by rejecting the misguided approach in this legislation.”
The letter was sent to House Speaker Mike Johnson (R-La.), Senate Majority Leader Charles Schumer (D-N.Y.), Senate Minority Leader Mitch McConnell (R-Ky.) and House Minority Leader Hakeem Jeffries (D-N.Y.).
The AMA is fighting scope creep, defending the practice of medicine against scope of practice expansions that threaten patient safety.
Why it matters: The AMA sent an opposition letter (PDF) to the House of Representatives when the bill was introduced there last year, but since then the proposed legislation has amassed a considerable number of cosponsors. If the bill were to be passed, physicians tell Congress that policy changes in the measure would “further stress the federal health care system that is already under-resourced and riddled with fiscal problems.”
“While we greatly value the contribution of pharmacists to the physician-led care team and recognize that pharmacists are well-trained in activities like dispensing pharmaceuticals, advising patients on the use of medications, and understanding drug-drug interactions, pharmacists’ training does not include diagnosing patients or formulating a plan of treatment,” says the the letter.
Notably, pharmacists must only complete four years of education, no residency and 1,740 hours of clinical training. By contrast, after earning a bachelor’s degree, physicians attend four years of medical school, spend three to seven years in residency and complete 10,000 to 16,000 hours of clinical training.
If the bill passes and pharmacists are allowed to evaluate, test and treat patients for COVID-19, influenza, respiratory syncytial virus (RSV) or streptococcal pharyngitis, a CLIA-waived test would guide the diagnoses.
“This is problematic because the results of a test alone are not enough to make a conclusive diagnosis or to rule out other complications,” physicians tell Congress in the letter. “Without a comprehensive physical exam by a trained professional done in the full context of the patient’s health, the severity of an illness is easily under-appreciated, and the underlying causes of symptoms may be overlooked.”
And while pharmacists are trained in the chemical components of medication, they don’t have the comprehensive medical knowledge that physicians do, according to the letter. Letting pharmacists initiate drug regimens and treat illnesses could lead to major complications if a patient’s full health record isn’t considered or documented in the electronic health record.
Learn more with the AMA about the differences in training between pharmacists and physicians.
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“Select COVID-19 therapeutics, while highly effective, are accompanied by multiple pages of information related to drug interactions which may negatively impact an individual’s health if their complete health history is not adequately considered,” the physician organizations explained in their joint letter. “Moreover, special populations, such as patients under 18 years of age or individuals who are pregnant or breastfeeding, require the specialty knowledge brought by a physician to make evidence-based, patient-centered decisions.”
The changes also could lead to patients forgoing wellness exams, comprehensive preventive care, early diagnosis and optimal therapy—each of which could result in “devastating long-term consequences” for the patient, the letter says.
Further, the AMA and the others pointed out, the bill would add more work to pharmacists who have reported they have workloads that are already too high. Over 70% of pharmacists in pharmacy chain settings and 91% of pharmacists in community pharmacies rated their workload as high or excessively high, according to survey results cited in the letter.
Learn more: Find out how the AMA is working closely with state medical organizations to defeat the numerous state scope of practice expansion bills introduced in legislatures in 2024.
The AMA also has a truth-in-advertising model bill designed to help ensure patients clearly know the credentials of the professionals treating them.
