Doctors say patients want them, not physician associates, to lead health care: AMA

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Patients prefer physicians to lead health care and the American Medical Association wants it to stay that way, the AMA’s leader said.

AMA President Bruce A. Scott, MD, responded to recent letters from the American Academy of Physician Associates (AAPA) asking for the physicians’ group to stop its campaign against legislative efforts to expand scope of practice for physician associates (PAs) and other clinicians. AMA calls it “scope creep,” but AAPA’s leadership claims those efforts against it are hurting health care. Instead, the two should meet to find common ground, according to AAPA.

All members of the health care team, including physician associates, have a role to play in health care, Scott said in his response. AMA values and respects their contributions, he said in the letter to AAPA President Jason Prevelige, DMSc, MBA, PA-C, DFAAPA, and CEO Lisa M. Gables, CPA.

“However, physician assistants have neither the same skill set nor the breadth of experience of physicians, as is evident by the fact that physician assistants have a fraction of physicians’ education and training,” Scott’s response letter said. “To claim otherwise is simply incorrect and even more critically, confusing to patients. This is why the AMA firmly believes that all patients, including patients in rural and underserved communities, deserve access to physician-led team-based care.”

Scope creep

AMA’s work on scope of practice arises from longstanding and extensive AMA policy and most often happens as a direct response to legislation, Scott said. Some of those bills use model language provided by AAPA, but the doctors believe those bills would dismantle the health care team, not enhance it, he said.

Bruce A. Scott, MD
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“We are proud of our efforts to defeat these bills and will continue to work tirelessly on behalf of our members and patients to preserve patient access to physician-led care, which survey after survey shows is what patients want,” Scott said. “This includes our most recent survey in which 95 percent of patients said they want and expect a physician to be involved in their diagnosis and treatment.”

AMA maintains a section of its website devoted to the issue and stated the organization in 2024 helped defeat more than 100 bills to expand nonphysician providers’ scope of practice.

Why should doctors lead? To start: “Compared with nurse practitioners, physicians have 20 times more clinical training. And while all physicians get vital hands-on instruction, 60% of NP (nurse practitioner) programs are mostly or completely online,” the AMA website said.

AAPA seeks responses

AAPA posted the AMA missive on its website and its leaders are asking PAs to share their feedback on the AMA response, by emailing Prevelige.

“AAPA values the input from all PAs as it carefully evaluates next steps in this ongoing effort,” the association’s website said. “AAPA remains committed to advocating for the best interests of PAs, and most importantly the well-being of patients.”

The response could be sizable. AAPA in summer amassed more than 8,000 physician associate signatures on another letter expressing their concerns to AMA.

The exchange began with AAPA’s July 30 letter to Scott seeking a meeting by the end of August “to discuss the impact of AMA’s disparaging rhetoric targeted at the physician associate profession.” A Sept. 3 follow-up letter said there was no response, but the issue was timely as 2024 winds down and lawmakers prepare for a new legislative year in 2025.