Massachusetts Medical Society: MMS Residents Advocate for Physician-Led Teams

MMS Residents Advocate for Physician-Led Teams

Scope of Practice Expansion May Not Help Patients

One of the most challenging and controversial issues facing physicians on Beacon Hill this year is scope of practice legislation.

There have been a number of proposed pieces of legislation seeking to grant independent practice to nurse anesthetists and nurse practitioners, including prescriptive authority and the ability to order and interpret tests.

Some of these proposals call for physician supervision to be completely eliminated.

Because physician-led teams are an essential element of high-quality medical care, MMS officials recently testified before the Joint Committee on Public Health in strong opposition to a number of legislative proposals that would allow increased independent medical practice by a variety of non-physicians. Among the proposals were a set of bills that would allow lay midwives, nurse midwives, nurse practitioners, and certified registered nurse anesthetists to expand their scope of practice.

Several MMS physicians, including Maryanne C. Bombaugh, M.D., and Hugh Taylor, M.D., chair and vice chair, respectively, of the Society’s Committee on Legislation, testified on behalf of the organization.

“The movement toward ACOs [accountable care organizations] and patient-centered medical homes requires integration and teamwork among providers to improve health care outcomes and reduce health costs. Physicians bring to the team the highest level of training and preparation, and thus are best suited to guide the other members of the team,” they said.

Some of the most compelling and effective testimony came from young physicians representing the MMS, who spoke about the importance of lengthy medical training and years of practical clinical experience.

Adeliza Olivero
Adeliza Olivero, M.D.

Adeliza Olivero, M.D., chief psychiatric resident at Boston Medical Center, questioned the benefits to patients if an advanced practice nurse with just four to six years of total training has the same clinical privileges as a physician with eight years of postgraduate education.

Matthew Libby
Matthew B. Libby, D.O.

Matthew B. Libby, D.O., a family medicine resident physician at Greater Lawrence Family Health Center, said it was a worthwhile challenge to make his voice heard among the varied stakeholders participating in the public hearing.

“Regardless of whether the bill ends up going to the floor for a vote, it was empowering and energizing to have our concerns and voices represented publicly,” he said. “This experience made me want to be more involved in advocacy.”

Read the full testimony on the scope of practice bills at

—Ronna Wallace 
MMS Legislative Consultant
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