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 AMA Escalates Campaign Against Nurses, Chiropractors, Naturopaths, Midwives and Others 
The following is one in an ongoing series of columns entitled Integrator Blog by . View all columns in series
Summary: In June meetings, the House of Delegates of the American Medical Association (AMA) kicked off an escalating round of attacks on the advancement of other healthcare professions. Targeted this year were all disciplines with doctoral-level training, as well as licensed midwives. Chiropractors, naturopathic physicians and nurses - who cited Wilk v AMA - are among those that have been quick to challenge the AMA. The AMA actions are part of that guild's divisive AMA Scope of Practice Partnership (SOPP), announced in January 2006. Meantime, one action at the House of Delegates meeting suggests that the snake on the AMA's caduceus may be biting its own tail. Resolution 235 is an effort to keep the AMA's own specialty societies from legislative actions that seek to restrict each other's scope of practice.

"Whereas, The economics of medicine have put financial pressure on all physicians ... "
- from the AMA House of Delegates "Friendly Fire" Resolution 235

Rooted in an old world view?
The American Medical Association has sought to escalate its war against advances of all other disciplines with action by their House of Delegates at their June 14-18, 2008 meeting. Four separate resolutions continued the AMA's Scope of Practice Partnership (AMA SOPP), formally established in January 2006. The AMA SOPP is a systematic campaign to limit the scope of practice of other professions, except MDs, osteopaths and dentists. In an AMA slide show made available to the Integrator, the AMA describes the
SOPP as "A Partnership to Oppose Unwarranted Nonphysician Scope of Practice Expansions."

The AMA SOPP has been relatively quiet since its initial flurry of activity. [For information on the initial efforts, see "AMA Scope of Practice Partnership" at Integrator Archive by Subject: 2006 or go directly to
AMA Targets Nursing Doctorate and ND License: Old Boys vs the Emerging Medical Matriarchy? (August 8, 2006), Coalition Battles AMA Campaign to "Thwart" Other Disciplines' Scope Expansions (June 21, 2006), and the August 2, 2006 article CAM-IM Responses to AMA Scope Campaign; Coalition Plans Next Steps. ]

The first round of this activity made it clear that the AMA did not make its case against the nursing doctorate, and against naturopathic physicians and others, based on evidence that these disciplines have caused harm. This second round of AMA activity appears to also lack an evidence base.

A point of clarity made in the
first round is that
the AMA did make its case against
the nursing doctorate, and against
naturopathic physicians and others
based on evidence that these
other disciplines have caused
harm by their scopes.

This round of AMA activity appears
to also lack an evidence base.

Below is basic information on the various resolutions in the current campaign, followed by some of the responses of the professional associations which the AMA is targeting.

Resolution 232 (formerly 303) - Protection of the titles "doctor", "resident," and "residency"

Directly in AMA's sights at the June 2008 meeting were the "doctor-nurses" - Doctors of Nursing Practice. But all other health professional practices with doctoral level training were also targeted by Resolution 232 (formerly Resolution 303). This Resolution, in its original form, would have clarified that only MDs, dentists and DOs should have any right to be called "doctor" in a medical setting. Only their fields could use the terms "resident" and "residency." The original resolution which was under consideration is printed at the bottom of this article. Notably, Illinois, which introduced the Resolution, is one of the states where chiropractors have their broadest scope and where naturopathic physicians are currently pressing for licensing.
Following debate, the AMA's House backed off. They acknowledged, as noted in the "Report of Reference Committee B" on House action, that "any individual who has received a terminal degree in their area of study has the right to be called 'doctor,'" according to a report on what was clearly a heated debate. The House chose to adopt a milder Substitute Resolution 232, which states that:

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Resumes are useful in employment decisions. I provide this background so that you may understand what informs the work which you may employ in your own. I have been involved as an organizer-writer in the emerging fields......moreJohn Weeks
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