ASHA is pressing the American Medical Association (AMA) to retract a recently released audiology scope of practice document. Citing factual errors and misstatements, 2009 ASHA President Sue Hale challenged several aspects of the document, including the assertion that effective patient care is best accomplished by means of physician oversight.

The AMA stated that the document is designed to “serve as a resource for state medical associations, national medical specialty societies, and policymakers” and intends to develop scope of practice documents for other health care professions.

In a Dec. 18, 2009, letter to Michael D. Maves, AMA executive vice president and chief executive officer, Hale challenged “the presumption of the AMA that it should develop such a document and especially for the stated purpose… One profession does not have the right to restrict the scope of practice of another legally recognized profession.”

Hale urged the AMA to retract the document, AMA Scope of Practice Data Series: Audiologists, and stated that it is “rife with opinions, misstatements, innuendos, and factual errors.”

AMA developed its document without conferring or collaborating with ASHA, the professional home for the discipline since 1925. “Such oversight begs the question as to the actual motives behind such a self-serving document and will most assuredly cause reasonable policymakers to doubt its credibility,” Hale said in the letter.

Hale also noted in her letter that sections of the AMA document suggested that political motives were behind the legitimate initiatives to expand the scope of practice of audiology; these statements overlook the fact that scope of practice legitimately grows as a profession’s research and knowledge base increases. She went on to state, “Just as in medicine, audiologists and hearing scientists spend careers developing best practices that are carefully evaluated to ensure patient safety and welfare, as well as the efficacy of interventions, while addressing the patient’s communication needs.”

The AMA document asserts that effective patient care is best accomplished by means of physician oversight, but this approach is not cost-effective, given that approximately 95% of adults with hearing loss have a sensorineural loss for which medical or surgical treatment is not typically beneficial. The document also “assumes a level of audiologic knowledge that does not exist for most physicians and presumes a model of health care that does not reflect society’s acceptance of autonomous allied health practitioners,” Hale said in the letter.

ASHA also took issue with the rationale noted within the document for moving the profession from the master’s to the clinical doctoral degree as the entry level for independent professional practice in audiology. “The true impetus for this change was the profession’s need for knowledge and skills to keep pace with the scientific, technological, environmental, and practice changes that were occurring,” Hale said.

Tommie Robinson, 2010 ASHA president, has reinforced ASHA’s position, saying that the profession of audiology will continue to establish its own scope of practice and that retraction of the AMA Scope of Practice Data Series: Audiologists is in the best interest of all concerned. To read the letter, search for “AMA scope of practice” online at ASHA’s Web site.