Dan Walters

Dan Walters

By Dan Walters
dwalters@sacbee.com
Published: Tuesday, Apr. 30, 2013 – 12:00 am | Page 3A
Last Modified: Tuesday, Apr. 30, 2013 – 7:57 am

Senate Bills 491, 492 and 493 won approval of a Senate committee Monday and we should all be afraid – very afraid – because once again, state legislators are voting on “scope of practice.”

It means that politics – sometimes raw politics – are determining which medical practitioner can perform which procedure on which part of the human body, rather than leaving those decisions in the hands of medical experts.

It’s not a new phenomenon. Scarcely a legislative session passes without at least one scope-of-practice issue arising. Some of those political battles have been barn-burners, such as podiatrists’ hard-fought battle to win the right to perform surgery on ankles, overcoming opposition from orthopedic surgeons.

That was 30-plus years ago, and since then we’ve seen opticians battle with optometrists, dental surgeons vs. plastic surgeons, psychologists vs. psychiatrists, nurses vs. physicians – even dog groomers vs. veterinarians over who had the legal right to brush dogs’ teeth.

This year, there’s a wave of bills to expand the scope of practices for a wide variety of medical specialists, generally intruding on the exclusive turf of medical doctors.

Why? Their sponsors say it’s because the state has too few doctors to deal with millions of Californians who now lack health insurance, but will obtain coverage under the new Affordable Care Act, so the state should expand access by allowing nurses, optometrists, pharmacists and others to take up the slack.

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