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News & Press: Member Editorials

House moves to expand scope of practice

Wednesday, March 20, 2019   (0 Comments)
Posted by: Dr. Mark Dobbertien
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By Mark Dobbertien, MD, FACS
DCMS Treasurer & FMA Surgical Specialty Board Representative


“If you work for a living, why do you kill yourself working?” – Tuco the Ugly


This famous line from Clint Eastwood’s The Good, The Bad and the Ugly could aptly describe the plight of physicians today. As we struggle with changing regulations, ever-changing legislation and reimbursement models, it becomes harder and harder to focus on our primary concern, our patients.

That’s why the DCMS and the FMA work diligently for you during Florida Legislative Session to ensure that the government overreach is not negatively impacting your practice. And sometimes, it’s a real struggle.

This year, I have been active in Tallahassee as a member of the DCMS Executive Committee and a Surgical Specialty Representative to the Florida Medical Association (FMA) Board of Governors fighting an onslaught of bills designed specifically to change the scope of practice for thousands in Florida. It’s not all bad, in fact, some of it is very good…

…and some is just downright ugly.


The Good

The Senate Health Policy Committee adopted a comprehensive rewrite of SB 732, which governs office surgery. As originally written, this bill would have required virtually every physician office in the State to become licensed as an ambulatory surgical center. As a result of the amendment, only facilities that provide significant surgical services would be regulated. The degree of regulation would be enhanced, however, in the wake of several abuses, primarily in cosmetic surgery clinics in Southeast Florida. We thank Senator Anitere Flores for working with us closely on this effort to enhance patient safety without over-regulating all physicians.

The House Civil Justice Committee passed a Committee Bill that would reinstate the caps on non-economic damages that had been stricken by the Supreme Court. The hope is that, with the replacement of three judges on the Supreme Court by Governor DeSantis, these caps may now be upheld by the new court.


The Bad

HB 833, which would allow Consultant Pharmacists to perform patient assessments and initiate drug therapies, was the subject of intense negotiation over the last two weeks. Unfortunately, those discussions did not produce an acceptable amendment, and we must continue to oppose the bill.

Another pharmacist bill, HB 111 would allow pharmacists to enter into collaborative pharmacy practice agreements with physicians, which would allow them to initiate or discontinue medications without the consent of the treating physician. This Bill has passed the Health Appropriations Committee and will be heard in the Health and Human Services Subcommittee Thursday. We will continue to oppose the bill. 


The Ugly

The House Health Quality Committee not only passed HB 821, which would grant independent practice to Advanced Practice Registered Nurses, but also amended the bill to create “autonomous physician assistants” that also could practice independently. We spoke vigorously against the bill, as did the FMA, but the bill was passed on a 10-3 vote.

As you can see, we have had an eventful two weeks, but nothing has yet been finalized, and we will redouble our efforts over the next few weeks.