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San Francisco Marin Medical Society Blog

California Senate Passes Two Bills That Would Expand Scope of Practice; Bills May Potentially Endanger Patient Safety

The California Senate passed two of three bills that aim to expand certain health care providers' scope of practice as a means to address California's primary care physician shortage.

The bills were introduced by Senator Ed Hernandez (D-West Covina), (SB 491, SB 492 and SB 493) that, respectively, would expand the scope of practice for nurse practitioners, optometrists, and pharmacists to address the physician shortage.

The Senate passed SB 491 and SB 492—which now go to the Assembly for consideration—and is expected to vote on SB 493 later this week.

Senator Hanna-Beth Jackson (D-Santa Barbara) said, "To allow nurse practitioners to practice without any oversight endangers the community." Adding that, "we really need to make sure that even if people live in underserved communities that they get the best health care we can provide."

SFMS and CMA strongly oppose these bills because they set a dangerous precedent of allowing non-physicians to practice medicine without being subject to the Medical Practice Act (MPA), which regulates the practice of medicine and in which violations may result in the loss of a medical license and possibly criminal prosecution. Ultimately, nurse practitioners, optometrists, and pharmacists would be providing the same services as physicians, with less training, while being held to a lower standard of care.

We believe in a thoughtful approach that will not jeopardize quality of care, potentially endangering patients’ safety and privacy. This is why physicians, nurses, patient advocates oppose SB 491, SB 492 and SB 493. It’s the wrong medicine for California.

Rather than rely on short-sighted fix, a responsible alternative is to focus on increasing primary care provider training; recruiting more physicians from outside California; and creating incentives for working in underserved areas. SFMS and CMA support the following approach:

  • SB 21 and AB 27, which allocates $15 million annually for the new UC-Riverside School of Medicine;
  • AB 565, which expands the Steve Thompson Loan Repayment Program to help repay medical school loans in exchange for students agreeing to practice medicine in underserved areas;
  • AB 1176, which creates residency positions in medically underserved communities by instituting insurer fees; and,
  • AB 1288, which requires the Medical Board of California to prioritize applications for physician licenses from those who plan to treat members of a medically underserved population.

Source: California Healthline, May 29, 2013.

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