TMA Defends Texas Law Regarding Physician Delegation and Supervision of the Performance of Medical Acts by Nurse Practitioners

Nov. 5, 2026    

Statement by Texas Medical Association (TMA) President Bradford W. Holland, MD. TMA filed a Petition for Intervention in McCoy v. Carlton, a lawsuit in Travis County filed by Texas Nurse Practitioners and two individual nurse practitioners against the executive directors of the Texas Medical Board and Texas Board of Nursing. TMA is seeking to intervene to defend the challenged Texas laws, which expressly exclude the practice of medicine from the definition of professional nursing and require physician delegation and supervision for nurse practitioners to perform certain medical acts. The legislature has concluded that such physician delegation and supervision are necessary to protect the health care of Texas patients. We strongly agree with that legislative judgment.  

“The Texas Medical Association is joining the lawsuit in support of the defendants, because we strongly support the legislature’s judgment that the challenged laws are necessary to serve the best interests of patients – to whose welfare TMA and our members are committed.

“This case is about who has the right to practice medicine in Texas, which is directly related to the quality of the medical care provided.

“Texas laws are both clear and constitutionally sound: Only physicians issued a license to practice medicine by the Texas Medical Board are authorized to practice medicine in our state. Indeed, the Nursing Practice Act explicitly defines professional nursing to exclude the practice of medicine.

“Nurse practitioners may only perform certain medical acts under a physician’s delegation and supervision. Doing so without a physician’s delegation and supervision constitutes the unauthorized practice of medicine under Texas law. Moreover, the challenged laws have one basic purpose: to help ensure that patients who receive these services are properly cared for.”

TMA is the largest state medical society in the nation, representing more than 60,000 physician and medical student members. It is located in Austin and has 110 component county medical societies around the state. TMA’s key objective since 1853 is to improve the health of all Texans.

-30-

TMA Contacts:  Brent Annear (512) 370-1381; cell: (512) 656-7320; email: brent.annear@texmed.org

Swathi Narayanan (512) 370-1382; cell: (408) 987-1318; email: swathi.narayanan@texmed.org

Connect with TMA on X, Facebook, and Instagram.