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Massachusetts Considers TIA, Definition of Surgery and APN Independent Practice Bills

The Massachusetts Joint Committee on Public Health had a robust agenda for its November 17 hearing, including legislation that would enact truth in advertising, define surgery and provide for the independent practice of advanced nurse practitioners, respectively. All three of these issues are trending nationally, and ASPS has taken a formal position on each as they have been introduced in various state legislatures. While the bills were heard for discussion only and no vote was taken, ASPS was on the record in support of both the truth in advertising and definition of surgery legislation, while strongly opposed legislation that would provide for the independent practice of advanced nurse practitioners.

Truth in Advertising

ASPS strongly supports truth in advertising (TIA) legislation and has engaged in TIA efforts nationwide. The Massachusetts TIA bill, S.1169, states that health care service advertisements that name a practitioner must also identify the type of license held by the practitioner. The bill mandates that a health care practitioner must visibly post his/her license and wear a photo identification name tag during all patient encounters. These IDs must include a recent photograph of the practitioner, the practitioners name, the type of license and the expiration date of the license.

ASPS notified plastic surgery affiliates in the region of the hearing and its plan to engage, including the Northeastern Society of Plastic Surgeons and the New England Society of Plastic & Reconstructive Surgery. In developing its advocacy strategy, ASPS worked very closely with the Massachusetts Medical Society, who was able to provide important information on local efforts. ASPS also notified the TIA Coalition, which is comprised of numerous physician specialty organizations, the American Medical Association, and the American Osteopathic Association. ASPS penned the TIA Coalition letter of support, which was submitted to the committee in addition to ASPS's letter of support. While ASPS noted our support for this bill, we also included comments about the importance of clear rules upholding high standards for physician advertising of board certification, which are not included in this legislation.

Definition of Surgery

ASPS has supported recent efforts in Connecticut and other states to define surgery. The Massachusetts bill, H.2012, states that the Board of Registration in Medicine has the authority to define the practice of surgery and that surgery is limited to physicians licensed by the board. This bill defines surgery as approved by the AMA House of Delegates and as approved by the American College of Surgeons. ASPS has strongly supported these definitions in the past.

ASPS worked closely with the Massachusetts Medical Society, who requested that the committee post the bill for a hearing. ASPS also notified the Northeastern Society of Plastic Surgeons and the New England Society of Plastic & Reconstructive Surgery.

APN: Independent Practice

ASPS has traditionally opposed efforts by advanced practice nurses to gain independent practice and thus opposed Massachusetts bill H.1889. ASPS believes that the bill's authorizing of APNs to independently practice represents a dangerous expansion of the APN's role in patient care that will ultimately be detrimental to a physician-centered, team-based health care delivery model and negatively impact patient quality outcomes. By permitting APNs to independently diagnose patients, prescribe medication and refer patients to specialists, this bill essentially permits an APN to step into the role of a primary care physician. This is wholly inappropriate and, ASPS believes, poses serious patient safety concerns. ASPS communicated our position to the Massachusetts Medical Society, the Northeastern Society of Plastic Surgeons and the New England Society of Plastic & Reconstructive Surgery.