Scope of Practice Efforts
2023 Issue Brief: Scope of Practice
WSMA policy states that absent commensurate education and training
requirements to ensure patient safety and a demonstrable and compelling
societal need, the WSMA opposes efforts of non-physician practitioners to
expand the scope of their practice to include additional services
currently performed by physicians.
Our ask of the Legislature in 2023
During the 2023 legislative session, the WSMA will ask the Washington
State Legislature to oppose scope of practice proposals that ignore the
unique training of physicians, fail to include necessary education and
training requirements, and jeopardize patient safety.
Scope bills we expect to see during the 2023 session
Naturopaths: Senate Bill 5411 would grant naturopaths
prescriptive authority for all Schedule III-V drugs, including opioids, without detailing specific
education and training requirements. A naturopath's educational emphasis
on the self-healing process does not include the comprehensive medical and
pharmacological background needed to properly and accurately prescribe
potentially dangerous prescription drugs like fentanyl, morphine, benzodiazepines, and ketamine
or to understand how they may interact with other drugs a patient may be
taking and other conditions they may have.
ARNPs: Senate Bill 5373/House Bill 1495 would mandate state insurance carriers
reimburse physician assistants and advanced registered nurse practitioners at the same rate as physicians for the "same services."
Due to their longer and more in-depth education and training, physicians
tend to work with higher acuity patients-those who present with multiple
complex conditions and require the highest level of clinical knowledge and
experience to treat appropriately and effectively. Insurance reimbursement
policies should have the flexibility to make distinctions in education and
Optometrists: Senate Bill 5389 would allow optometrists to
perform certain surgical procedures, including those that require the use
of scalpels, injections, and lasers on the eyes and tissues surrounding
the eyes, without appropriate education and training or regulatory
guardrails. Optometrists are not medical doctors, and their education is
observation-based. Only an ophthalmologist has training in the safest and
most advanced treatments of the eye-surgical, pharmacological, and other
interventions-as well as training in surgical procedures and techniques to
ensure patient safety.
Psychologists: House Bill 1041 would allow, under certain
conditions, psychologists to be granted prescriptive authority for
psychotropic medications used in the diagnosis and treatment of
individuals with certain mental and behavioral disorders. Psychotropics
include some of the most dangerous drugs and require a high level of
expertise and medical training, especially because psychotropic drugs can
have complex interactions with other drugs and most behavioral health
patients are receiving treatment for other health conditions.
Background on the education and training requirements by practitioner type
Contact WSMA Director of Government Affairs Sean Graham at
email@example.com or 360.259.4184.