Through years of medical school, residency and fellowships, physicians earn not only more knowledge and expertise than any other health professional, they also earn the right and responsibility of leading the health team. It is through physician-led care that we ensure continued quality and safety for patients. But each year, “scope creep” proposals seek to “replace medical education with legislation” and to blur the lines between medicine and other health disciplines.
Legislators, when confronted with such proposals, often ask how they can be expected to determine whether a particular piece of health legislation is in their constituents’ best interest. After all, the extent of most legislators’ experience with health care is only on the patient side. While muscle soreness can be alleviated by applying heat, legislators reviewing scope legislation would be well served by, as explained below, just applying H.E.A.T.
What is HEAT?
Could the proposal harm patients and will its effects adhere to the Hippocratic Oath’s directive to “first, do no harm?”
Do the proponents of the proposal have the requisite education today to safely perform the tasks or functions they are seeking to amend the law to allow; and, have all members of the profession to whom the proposal would apply received the same levels of specified education to cover the subject of the proposal?
Would the proposal expand access to additional quality care for patients or just additional care, perhaps of a lower standard?
Do proponents of the proposal possess the requisite training at present to perform the tasks they are seeking to amend the law to allow?
What does it mean?
If the answers to any of the above questions is no, then the answer to the legislative proposal in question should likewise be a resounding “no.” Medical education, residency and fellowships prepare physicians for the challenges of delivering quality care in today’s ever-changing health landscape. While proponents of “scope creep” pitch their proposals as cure-alls for the state’s health delivery system, there are no shortcuts to addressing Alabama’s health challenges.
To the contrary, removing physician supervision and reducing safety standards and protocols will only endanger patients and reduce quality. By investing in and supporting programs, proposals and initiatives that recruit and retain physicians to this state, legislators can grow the physician workforce, maintain quality of care and boost Alabama’s economy.
In the meantime, lawmakers utilizing the four-step HEAT process to analyze legislative proposals should find it helps them separate appropriate changes to Alabama’s health laws from the many dangerous “scope creep” bills that are on the increase.