The American Osteopathic Association calls for truth in advertising, intellectual honesty, and transparency with the use of professional designations of non-physician clinicians in service of the public interest.
We also call for organized, collaborative discussions among stakeholder organizations in the Physician, Advanced Practice Registered Nurse and Physician Assistant communities to find common ground on these important topics.
The American Osteopathic Association (AOA), which proudly represents its professional family of more than 151,000 osteopathic physicians (DOs) and medical students nationwide, is deeply concerned by the potential harm to patient care and patient safety resulting from the erosion of physician-led, team-based care. A physician-led team ensures that professionals with the highest level and most extensive degree of medical education and training are adequately involved in clinical decisions and patient care. "Physician-led" does not imply "physician optional."
The AOA, and the physicians whom we serve, value the important contributions made to our healthcare system by our non-physician colleagues. Advanced Practice Registered Nurses (APRNs), Physician Assistants (PAs), and others have worked tirelessly with physicians to care for patients prior to and throughout the COVID-19 pandemic, often under suboptimal and emergency conditions that put their own health and safety at risk. Their selfless service is to be commended. However, it is important to recognize that there is no substitute for the unique and extensive education and training that provides the foundation for physician-level medical decision making.
Non-physician clinicians, including APRNs and PAs, are an integral part of physician-led healthcare teams. Healthy discussions and collaboration, regarding safe and appropriate skill set substitution, roles and responsibilities are in order, and we welcome them. However, recent rhetoric has limited this important discussion to claimed territory and optical positioning through the use of professional titles, such as "Doctor" in a clinical setting by non-physicians and "Physician Associate" without consultation with the physician community. Further, we recognize the struggle of achieving professional parity (i.e. scope of practice, prescribing and compensation) between APRNs and PAs. However, efforts to seek parity among non-physician clinicians must not be at the expense of the truth in advertising and clarity of roles in our healthcare system.
There are important differences between the education and training requirements for physicians and non-physician clinicians. Physicians across the United States, osteopathic (DO) and allopathic (MD) alike, must meet the same education, postgraduate training and testing requirements and practice in supervised environments that afford progressively greater autonomy before ultimately becoming eligible to treat patients on their own through licensure competency assessment and rigorous board certification standards. These requirements ensure that all patients are treated safely and with the same standard of care.