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Scope of practice expansion is a long-standing, continuous and complex concern in the health care field. AAPM&R is aware of the various concerns specifically plaguing physiatrists, from non-physicians to non-physiatrists, intent on expanding their scope of practice beyond their level of education, training and experience. 

AAPM&R is taking action.

Your Academy remains vigilant about ongoing efforts by non-physician and non-PM&R providers to expand their scope of practice beyond their level of education, training and experience, which may threaten the health and safety of patients and impact the livelihood of physiatrists.

Federal and State Advocacy Actions in 2023:

  • In August, AAPM&R launched an ongoing federal grassroots campaign to contact members of Congress and express opposition to H.R. 2713, the Improving Care and Access to Nurses (ICAN) Act. This legislation would inappropriately expand scope of practice for non-physician practitioners including nurse practitioners, certified nurse midwives, certified registered nurse anesthetists, clinical nurse specialists and physician assistants. Academy members, click here to participate in this campaign.
  • In June, AAPM&R joined the American Medical Association (AMA) and more than ninety medical societies and associations in submitting a letter to congressional leadership in opposition to H.R. 2713.
  • In May, AAPM&R organized an ongoing Federal grassroots campaign to contact members of Congress and express opposition to S. 131/H.R. 618. To date, Academy members have responded strongly to this campaign, sending more than 560 letters to Congress to stop the expansion of scope of practice for nurse practitioners and physician assistants under the federal Worker’s Compensation Program. Academy members, click here to participate in this campaign.
  • In March, AAPM&R launched a grassroots campaign for Academy members in New York to stop the elimination of oversight of physician assistants in Part W of the Governor’s proposed Health and Mental Hygiene Budget (A.3007/S.4007). Academy members sent more than 80 letters to state officials in this ultimately successful advocacy effort. The final budget was signed by the Governor on May 3 and the provision eliminating the oversight of physician assistants was removed.

AAPM&R's Scope of Practice Workgroup

Recognizing the growing concern of non-physician (and non-PM&R) scope of practice expansion, your Academy is addressing this issue through multiple committees, including a new Scope of Practice Workgroup. This workgroup is comprised of representatives from the Quality, Practice, Policy, and Research (QPPR) Committee, the Health Policy and Legislation (HP&L) Committee, and the Reimbursement and Policy Review Committee (RPRC), and AAPM&R’s representative to the AMA Scope of Practice Partnership (SOPP).

Scope of Practice Partnership with the American Medical Association (AMA)

Your Academy, as a member of the AMA Scope of Practice Partnership (SOPP), actively engages in the collaborative effort of the AMA, American Osteopathic Association (AOA), national medical societies, state medical associations and state osteopathic medical associations to oppose scope of practice expansions by non-physician providers that threaten the health and safety of patients. The SOPP achieves this goal through legislative activities, regulatory activities, judicial advocacy, and programs of information, research and education. Active participation in this collaborative ensures physiatry is represented and contributes to SOPP’s goal to protect the health and safety of patients whose well-being may be threatened by health care practitioners who lack the education, training or experience to perform procedures for which they seek licensure or recognition.

Resources

From ongoing collaborations with the American Medical Association (AMA) to a full toolkit of position statements, we plan to continue developing tangible resources to assist physiatrists in addressing scope of practice issues.

Your Academy's Latest Efforts to Defend Physiatrists' Scope of Practice

View the full list of AAPM&R advocacy letters.


AAPM&R Issues Position Statement on the Proper Use of ‘Physical Medicine and Rehabilitation’ and Derivatives

Feb 10, 2020

In response to members’ concerns regarding non-physician and non-PM&R physician practices improperly using the term “Physical Medicine and Rehabilitation” to describe themselves and their services, AAPM&R has released a Position Statement on the appropriate use of the term and its derivatives.

Physiatrists can use this advocacy tool to combat inappropriate use of the specialty’s name and protect those seeking care from the spread of misinformation.

AAPM&R believes “Physical Medicine and Rehabilitation” and its derivatives, such as “physical medicine,” “rehabilitation medicine,” and “PM&R,” are specific to titles of a physician gained through rigorous medical education and experience unique to the PM&R specialty. “Physical Medicine and Rehabilitation” is not a general designation applicable to any or all clinicians working in broader rehabilitation care settings.

Physiatrists are Medical Doctors (M.D.) or Doctors of Osteopathic Medicine (D.O.) who specialize in physical medicine and rehabilitation (PM&R). To become a physiatrist, individuals must complete medical school and four additional years of postdoctoral training in a physical medicine and rehabilitation residency. This includes one year developing fundamental clinical skills and three additional years of training in the full scope of the specialty. The unique experience and expertise that physiatrists gain during their residency training is not replicated in any other training program and is what defines a physiatrist as a physical medicine and rehabilitation physician.

The Academy believes this term and its derivatives should be strictly reserved for highly trained physiatrists and the services they provide. Using PM&R to describe services offered by health care providers who are insufficiently trained in the specialty causes confusion among patients and payers, threatens the health and safety of patients, and jeopardizes the reputation and quality of care standard to the specialty.

Physiatrists should use AAPM&R’s Position Statement as a tool to educate the public and their patients, so that they can make informed decisions when seeking care, as well as to protect the integrity of the specialty.

Read the full Position Statement.

A special note of thanks to members of the Quality, Practice, Policy, and Research (QPPR) Committee for their critical work on this statement, which was swiftly approved by the AAPM&R Board of Governors on January 28, 2020.