Advanced practice nurses: a new skirmish in the continuing battle over scope of practice.

I n 1999, this column described the hotly contested efforts of advanced practice nurses (APNs) to define in federal regulations relationships between APNs and physicians that recognized the full scope of practice and quality of care of APNs. With the new skirmish described here, the battle continues. In June 2006, the deceptively titled Healthcare Truth and Transparency Act (HR 5688) was introduced by Congressman Sullivan, with co-sponsorship by Congressmen Green (Texas), and was referred to the Committee on Energy and Commerce. Eleven cosponsors, all Republicans, signed onto the legislation, including Representative Charles Bass (NH), Representative Michael Bilirakis (FL), Representative Michael C. Burgess (Texas), Representative Barbara Cubin (Wyoming), Representative John R. Randy Kuhl (New York), Representative Jim McDermott (Washington), Representative Joseph R. Pitts (PA), Representative Ted Poe (Texas), Representative John J. H. Joes Schwartz (Michigan), Representative Pete Sessions (Texas), Representative John E. Sweeney (NY), and Representative Gene Green (Texas), who withdrew his co-sponsorship on June 28, 2006. This bill pits organized physician groups against APNs and other nonphysician providers. The bill, designed to limit selected scopes of practice, creates a federal cause of action against nonphysician healthcare professionals who ‘‘make any deceptive or misleading statement, or engage in any deceptive or misleading act, that deceives or misleads the public or a prospective or current patient that such person is a medical doctor, doctor of osteopathic medicine, doctor of dental surgery, or doctor of dental medicine or has the same or equivalent education, skills, or training.’’ Penalties for misleading consumers about their licensure, scope of practice or expertise, or misrepresentation include treatment of the act as a violation of section 5 of the Federal Trade Commission Act (15 U.S.C. 45). The bill would compel the Federal Trade Commission to conduct studies of what are perceived unfair and deceptive acts and practices: