Remember the "Scope of Practice Partnership," that vague entity developed by the American Medical Association in 2004 with an equally vague, yet ominous mission: to monitor and investigate scope-of-practice issues involving non-MD/DO health care professions? Well, its newest member is the North American Spine Society, which produces The Spine Journal and boasts doctors of chiropractic among its multidisciplinary membership. In June, the NASS Board of Directors approved a recommendation from its Health Policy Council and Advocacy Committee to join the Scope of Practice Partnership, petitioned the AMA and was subsequently approved for membership.
According to a NASS press release, the partnership "is a coalition of 50 state medical societies, more than 25 national specialty societies, the American Osteopathic Association and the AMA. The coalition works to address concerns regarding training and education, state regulations, legislative licensure efforts by non-physicians and general scope-of-practice issues." The release also states that the NASS Advocacy Committee will oversee legislative and regulatory activities related to scope of practice, and urges members to contact the committee with any concerns regarding "a scope of practice initiative in your state."
Sound harmless? Consider that this "coalition" and its mission have spawned such AMA directives as Resolution 814, designed to "study the qualifications, education, academic requirements, licensure, certification, independent governance, ethical standards, disciplinary processes, and peer review of the limited-licensure health care providers, and limited independent practitioners," and Resolution 904 ("Diagnosis of disease and diagnostic interpretation of tests constitutes [the] practice of medicine to be performed by or under the supervision of licensed physicians").
DC contacted NASS for an official statement following its announcement and received the following, courtesy of Senior Advocacy Manager Nick Schilligo:
"NASS is a multidisciplinary medical organization dedicated to fostering the highest quality, evidence-based, and ethical spine care by promoting education, research, and advocacy. Care of patients with spinal disorders includes a vast array of treatments available including surgery, injections, spinal manipulation, physical therapy, and other treatment modalities.
"NASS is joining the American Medical Association's Scope of Practice Partnership to learn more about scope-of-practice issues and to allow all of its members to continue to provide the high-quality spine care they are trained to deliver to patients. NASS will evaluate scope-of-practice issues on a case-by-case basis and weigh in on these issues based on the merits of the information presented on the issues at hand.
"NASS will remain an independent and reasonable voice for high-quality spine care, and will continue to serve as a voice, where appropriate, for all of its members. Spine care providers, regardless of specialty, should continue to become members of NASS in order to join their colleagues in ensuring that patients receive the highest possible level of care for spinal disorders."
As of press time, it is unknown how this action will affect current chiropractic membership within the organization, although one can speculate that both member and nonmember DCs may consider NASS' participation in the Scope of Practice Partnership before continuing their association with or joining NASS from this point forward.
For background information on the Scope-of-Practice Partnership, read "AMA Creates 'Partnership' to Limit Other Providers' Scope of Practice" in our June 6, 2006 issue and "AMA Scope of Practice Partnership Tightens Its Grip" in the Jan. 15, 2007 issue.