The AMA’s “Scope Creep” Campaign is Myopic: Here’s Why Limiting Healthcare Access Hurts Everyone

There are many problems with American healthcare but one thing is clear: we need more providers. But instead of focusing on solutions, the American Medical Association (AMA) is pushing a campaign against what it calls “scope creep.” While the AMA frames this as a patient safety initiative, here’s the truth: this campaign isn’t just short-sighted—it’s downright bad for patients and the system.

To be clear, “scope creep” isn’t about sneaky baristas at Starbucks doubling as surgeons. No, the term refers to highly trained healthcare providers like physician associates (PAs) who are ready and willing to practice medicine to the full extent of their licenses, allowing them to meet patient demands better. However, rather than championing increased access to affordable healthcare, the AMA seems to think these providers are overstepping.

Here’s why this campaign is a classic case of misplaced priorities, how it could harm patients, and why the future of American healthcare needs more well-trained clinicians performing at the very height of their training.

Understanding “Scope Creep” and Why It Matters

The AMA’s “scope creep” campaign paints an alarming picture, but let’s dissect what this term means. Scope creep refers to efforts by non-physician clinicians, also known as advanced practice providers (like PAs and NPs) to practice at the top of their training. These clinicians aren’t out to play doctor (though many of them have doctorates and may rightly be called doctor); they’re working to provide accessible, high-quality care to patients who need it.

Physician Associates, for instance, complete a master’s program, pass rigorous exams, and undergo thousands of hours of supervised clinical training. Many have now completed the Doctor of Medical Science (DMSc) degree to refine their clinical and leadership skills. 

While the AMA wants you to believe scope expansion is risky, the numbers tell a different story. Research consistently shows that outcomes for patients treated by PAs and NPs are comparable to those treated by physicians, especially in primary care settings. And in medically underserved areas, PAs and NPs are often the only reliable sources of healthcare.

The Consequences of Limiting Scope Expansion for Patients

The AMA’s campaign against scope expansion doesn’t just limit PAs and NPs—it limits patients and their access to care. America has a massive physician shortage, particularly in rural and underserved urban areas. According to the Association of American Medical Colleges (AAMC), the U.S. could face a shortage of 86,000 physicians by 2036. But the solution could be sitting right in front of us: enabling qualified PAs to practice without undue administrative burden.

Restricting their scope of practice doesn’t protect patients; it creates barriers. Studies show that patients in states where NPs have full practice authority have better access to care, shorter wait times, and lower healthcare costs. In contrast, states with restrictive scope-of-practice laws see higher ER visits and longer wait times, as patients struggle to find available providers.

The Financial and Practical Benefits of Expanding Scope

Let’s talk numbers. Healthcare in the U.S. is among the most expensive in the world, and restricting provider scope does nothing to alleviate that. Limiting scope-of-practice increases costs. 

Dies and Taylor found that PAs reduce wait times. Van den Brink and Hooker found that PAs not only delivered the same or better care outcomes as physicians but that they did so with the same or less cost of care. DePalma and DePalma report that removing restrictive laws and regulations to PA practice does not increase overall risks to patients or increase rates of malpractice

Clearly, eliminating administrative burdens on PA practice doesn’t mean compromising on quality.  If the AMA were truly advocating for patients in an overburdened system full of burned out clinicians and sky-high healthcare costs, why don’t they at least advocate for a team-based model that saves money and gets patients treated faster?

Addressing “Safety Concerns” and the Underlying Motives

The AMA’s main argument for restricting scope expansion hinges on patient safety. But let’s look at the facts: There is a wealth of evidence showing that PAs and NPs provide safe, high-quality care, particularly in primary care settings where they’re most needed. And since primary care Physician Associates refer complex cases to the same specialists, they’re more than capable of handling even the most difficult cases without compromising safety.

The more likely reason for the AMA’s stance is concern over competition rather than patient safety. But healthcare shouldn’t be about turf wars—it should be about patient outcomes. To put it simply, a sick patient who’s seen quickly by a PA is better off than one who waits weeks or months to see a physician. And in rural areas, where physicians may be few and far between, PAs and NPs are essential lifelines.

The American Academy of Physician Associates (AAPA) has penned multiple open letters to the AMA requesting that the AMA stop its assault on an already broken system:

“75 million patients are without adequate access to primary care, and 122 million are without adequate access to mental healthcare. In this critical moment, the focus must be on building a stronger, more resilient healthcare system — not on tearing down other professions.”

AAPA points out that in 2023 alone the AMA obstructed more than 100 bills aimed at expanding access to care and modernizing healthcare laws. AAPA continues, “Your campaign against ‘scope creep’ is a thinly veiled effort to maintain outdated practices, rather than confronting the urgent issues we face today.”

The AMA’s myopic scope creep campaign has done nothing but hurt patients and providers. According to the AAPA, 95% of PAs believe that the AMA’s campaign has negatively impacted efforts to expand access to care for patients. 90% report that the campaign has negatively impacted the healthcare system as a whole. 90% of PAs feel that the AMA’s campaign has negatively impacted patients’ understanding of PA qualifications to provide care. Where’s the sense in that?

And what’s more, AMA refuses to meet with AAPA to discuss a path forward. 

What a Future Without Scope Creep Limits Could Look Like

Imagine a healthcare system where highly trained clinicians can use all of their skills without artificial and antiquated barriers. Patients in rural areas could see a provider without driving hours for a simple checkup or in-office procedure. PAscould open practices in underserved areas, providing continuity of care without delays. And patients everywhere could receive timely, affordable care when they need it most. 

Patients want capable healthcare providers, doing everything they’ve been trained to do. In 2023, The Harris Poll reported that the public, i.e. our patients, had the following to say about PAs and “scope creep”:

• 91% think PA practice laws should be updated to allow states and healthcare systems to fully utilize their healthcare workforce. 
• 91% value PAs and see them as a solution to the ongoing workforce shortages.
• 90% view PAs as trusted healthcare providers.
• 95% feel that PAs make patients feel valued.
• 93% believe PAs add value to healthcare teams
• 89% believe PAs improve healthcare outcomes.
• 88% think PAs improve the quality of care. 
• 67% of those who have seen a PA would trust a PA to serve as their primary care provider.

The US is not alone in discovering a need for a fast track to the exam room. The UK and New Zealand, for example, have embraced this model, integrating non-physician practitioners into their systems to address provider shortages. The results? More accessible care, more job satisfaction for providers, and reduced healthcare costs. By limiting scope, we’re turning our backs on a better, more efficient system.

Prioritizing Patients Over Turf Wars

The AMA’s “scope creep” campaign misses the mark by placing unnecessary restrictions on providers willing and ready to help patients. With rising healthcare costs and a physician shortage, we need solutions that make sense—not selfish restrictions. A future where PAs, NPs, and other clinicians practice at the top of their training isn’t just possible; it’s essential.

So, next time you hear someone warning against “scope creep,” ask yourself: Is it really about patient safety, or is it about protecting turf? Because in healthcare, the focus should be on one thing: providing patients with the timely, high-quality care they deserve.

The truth is, most patients don’t care who provides their care, as long as they do it well. If the white coat fits, wear it.