Elizabeth Hovde of the Washington Policy Center believes this scope-of-practice expansion makes sense and should help lead the way to other places lawmakers can improve Washingtonians’ access to health care services

Elizabeth Hovde
Washington Policy Center

This isn’t a super interesting policy proposal. It won’t likely be the subject of passionate retweets or get shared widely on social media. Nor does the problem addressed by House Bill 1039 have people throwing shoes at their TV screens in frustration. But it’s important. This scope-of-practice legislation would allow qualified and trained physical therapists to perform intramuscular needling on patients who want the pain relief the treatment can provide. 

“Scope of practice” describes the services that a qualified health professional is able and allowed to perform. Some scope-of-practice limitations in the medical world can mean that patients suffer unnecessarily waiting for appropriate care. And scope-of-practice expansions, when done safely, can help patients — and solve some of the state’s workforce issues in health care. 

Workforce issues are said to be a 2023 legislative priority, as they should be, and HB 1039 offers one solution. The bill received near-unanimous, bipartisan support in the House. Senators should now pass the legislation. 

This practice is one that the military and 45 other states already allow physical therapists to do. Patients and caregivers who relocate here are often surprised and disappointed by the limitation.

Increasing access to intramuscular needling — a therapy for the management of neuromusculoskeletal pain and movement impairments that both proponents and opponents of HB 1039 say can benefit patients — would be done safely. In fact the bill’s sponsor, Rep. Nicole Macri, D-Seattle, brought this bill forward motivated by the desire to find safe alternatives to the use of opioids in pain management. Pain relief without medications that can have adverse impacts is a good goal. 

Opponents of the bill say not enough training is required of the physical therapists who would be allowed to perform the practice, but 45 other states have a lower training requirement than the 325 hours of instruction and clinical experience laid out in HB 1039, proponents argue. And the opposition looks like turf-war argumentation to me, with a desire to protect acupuncturists from possible competition to their practice. 

Patient-centric policies should rule the day, not turf. Physical therapists can be trained appropriately to offer intramuscular needing treatments, and more patients can have access to the pain management intramuscular needling can provide. 

To learn more, read the bill report outlining the latest ongoings with this good idea that has been tweaked over the years in hopes of eventual reception. You can also watch testimony on HB 1039 in the House here or more recently in the Senate here.

This scope-of-practice expansion makes sense and should help lead the way to other places lawmakers can improve Washingtonians’ access to health care services. More access can also help lower the price of care and increase quality. That’s something everyone could use to reduce some pain. 

Elizabeth Hovde is a policy analyst and the director of the Centers for Health Care and Worker Rights at the Washington Policy Center. She is a Clark County resident.

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