On June 9, 2026, the AMA House of Delegates, concerned that unsupervised nurse practitioners (NPs) and physician assistants (PAs) provide patient care that is not as good or safe as that provided by physicians, voted to fund independent studies that compare outcomes. The studies will look at patient safety, care quality, utilization, access, cost, and health outcomes, with a goal of publication in a peer-reviewed scientific journal.
Speakers at the meeting said state regulatory agencies need data based on science in order to set scope-of-practice rules. Several delegates said they have been referred to see patients who were previously inappropriately treated by mid-level providers.
The original resolution was that the AMA would merely advocate for and support such studies. But after discussion, it was amended to specify that the AMA will “fund independent, academically rigorous studies performing comparative effectiveness analyses of patient outcomes between autonomous non-physician practitioners and physician-led (MD/DO or foreign equivalent) care models.”
The joint resolution was introduced by the delegations from Florida, Texas, and Oklahoma. The Florida delegate stated, “We know these [prior] studies are referring to patients that are being seen for low conditions, for simple problems and always involve physician oversight. But legislators are not hearing these caveats. We need rigorous, independent data on the safety, efficacy, and cost of unsupervised NPs and PAs, and we need it urgently.”
A spokesperson for the American Academy of Pain Medicine cited Medicare data indicating “an explosion of nurse practitioners providing unsupervised advanced chronic pain injection therapies with unclear oversight and accreditation processes,” stating that an essential pain procedure code was flagged for overutilization, but the claims did not come from physician proceduralists: “This is a wake-up call. The nursing organizations are not going to fund legitimate comparative studies because they know what the outcomes will be.”
Pushback to the resolution included from the American College of Obstetricians and Gynecologists delegation: “I think that it’s a clear conflict of interest when we are specifically looking at studies to say that our care is superior to others. I think that’s true … but who else is going to believe that that is true? The nurse practitioner agencies, the physician assistant agencies will not, and our legislators are swayed by their testimony significantly.”
Delegates clarified that the intent is that the AMA will find legitimate researchers who will conduct the studies honestly and objectively.
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