Go to AAD Home
Donate For Public and Patients Store Search

Go to AAD Home

Putting patient safety first by preventing scope creep

Image for Impact Report

We continue to see dangerous non-physician scope of practice expansion efforts across the country, jeopardizing patient safety. But even with the rise in non-physician clinicians attempting to add dermatology to their services, we know that board-certified dermatologists know the specialty best.

The AADA continues to advocate against state legislation that weakens the quality and safety of specialty care. In 2022, in partnership with state dermatology and medical societies, we defeated scope expansion bills in:


The AADA worked with the Colorado Dermatologic Society and the American Society for Dermatologic Surgery Association to defeat legislation that would have allowed physician assistants (PAs) to practice medicine without any safeguards. Physician collaboration would only be required for PAs with fewer than 3,000 hours of practice experience or those beginning practice in a new specialty.

New Hampshire

The AADA advocated against legislation that would have allowed naturopaths to serve as medical directors in the medical spa setting. The legislation was sent to a study, effectively defeating the bill this session, and providing an opportunity to improve the language.

South Dakota

The AADA supported the South Dakota State Medical Association’s advocacy efforts that successfully rejected legislation authorizing PAs to practice independently upon completion of 1,040 hours of clinical practice.


Cheers to Wisconsin Gov. Tony Evers, who vetoed legislation that would have given independent practice to advanced practice registered nurses (APRNs). The AADA opposed this legislation that would have removed physician supervision/collaboration requirements of nurse practitioners, nurse anesthetists, and clinical nurse specialists after 3,840 clinical care hours in their respective APRN role with a physician or dentist. For nurse midwives, the legislation would have removed the collaboration requirement altogether.

We know that, ultimately, your patients are the ones at risk when scope is expanded for non-physician clinicians who do not have the same education and training as dermatologists, and we will continue to fight for the integrity of your specialty and your expertise.