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The case against expanding nonphysician scope of practice

by Gus Iversen, Editor in Chief | March 22, 2023
Business Affairs X-Ray
Early in March, the ACR issued a statement describing scope of practice bills as "rampant" in state legislatures. Iowa, Missouri, Montana, New York, and Texas are among the states weighing proposals to increase the decision-making authority of non-physicians.

In order to better understand the policies and politics behind these proposals, HCB News reached out to Eugenia Brandt, ACR's director of Senior Government Affairs. Here's what she had to say.

HCB News: From a radiology perspective, what is at stake with this wave of bills that expand non-physician practice?
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Eugenia Brandt: We are seeing an increasing number of bills seeking blanket expansion of scope of practice for non-physician personnel, especially for independent practice, authority to supervise use of ionizing radiation, and interpretation of diagnostic imaging or other tests. This is concerning as expanding scope of practice jeopardizes patient safety.

(Note: ACR is tracking these bills online).

Most radiologists undergo 10 years of comprehensive training beyond their undergraduate degree. Compared to physicians, the non-physician personnel education lacks standardization and, in a majority of cases, misses altogether the curriculum needed to supervise and interpret diagnostic imaging, especially more complex studies. Physicians specializing in radiology complete a rigorous educational and training framework that far exceeds those of non-physicians:

Graduate from medical school.
Serve a one-year clinical internship.
Complete four-year residency, during which radiologists: interpret tens of thousands of exams with practicing radiologist supervision and train in radiation safety, anatomy, pharmacology, pathophysiology, medical physics, radiobiology and more.
Complete a four-week (130 lecture hours) intensive radiologic pathology correlation course.
Pass a state licensing exam.
Complete a one-to-two-year fellowship of specialized training in a radiology subspecialty.

ACR supports a physician-led team approach within an integrated healthcare team. Proper supervision of procedures involving ionizing radiation and interpretation of diagnostic imaging exams by highly trained radiologist physicians is critical to accurate diagnosis and treatment of disease, injury and illness. Moreover, data shows that patients prefer a physician-led healthcare team. Per an AMA survey 95 % of patients polled said it was important for a physician" to be involved in their diagnosis and treatment.

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