SB-0746: Pupil health: physical examinations

Session: 2017-2018
Author: Portantino
Status: Signed into Law (Chaptered)
AAP-CA Position: Oppose
To view the status of this bill on the State Website, click here.

SB 746 (Portantino) would allow chiropractic doctors, naturopathic doctors, or nurse practitioners practicing in compliance with the law to perform the required pre-athletic physical examinations for student athletes.

AAP Positional Letter

March 24, 2017
The Honorable Anthony J. Portantino
State Capitol, Room 3086
Sacramento, CA 95814
Fax: (916) 651-4925

RE: SB 746 (Portantino): Pupil health: physical examinations AAP-CA Position: OPPOSE

Dear Senator Portantino:

The American Academy of Pediatrics, California (AAP-CA), representing over 5,000 California pediatricians, respectfully opposes your proposed legislation SB 746 (Portantino). This bill would permit chiropractic doctors, naturopathic doctors, and nurse practitioners to perform the required pre-athletic physical examinations for student athletes, thus expanding the scope of practice of these professions.

Among the main purposes of pre-athletic physical exams is the detection of structural and physiological cardiac irregularities that, combined with intense physical exertion, could cause sudden death in otherwise healthy adolescents. Non-physician practitioners, such as those that SB 746 (Portantino) would allow to perform pre-athletic physicals, are not trained to detect these problems. Allowing them to perform these physicals in lieu of physicians could substantially increase the risk of tragic and entirely avoidable accidents and deaths.

Additionally, naturopathic doctors and chiropractic doctors typically do not have specialized training in pediatric health, which means that they would not be adequately equipped to catch other potential health issues in children and adolescents. As a matter of American Academy of Pediatrics policy, “any health care professional who wishes to actively participate in the care of children must demonstrate appropriate education, training, skills, and ongoing competencies in pediatric health within his or her scope of practice to ensure the highest standards of care.” We are also concerned about the efficacy and safety of naturopathic services. As the California Medical Association has written previously, “The distinctive philosophy of naturopathic medicine and many of its methods of diagnosis and treatment are unscientific in concept, biologically improbable and clinically unproven.” Extensive documentation of the safety and efficacy of naturopathic practice should be expected before any expansion of their scope of practice is implemented, especially with relation to children.

For these reasons, we respectfully oppose SB 746 (Portantino). California pediatricians thank you for your public service and leadership, and appreciate your consideration of our concerns about your proposed legislation.


Jacques Corriveau, M.D., Fellow of the American Academy of Pediatrics
Chair, State Government Affairs Committee, American Academy of Pediatrics, California

CC: Kris Calvin, CEO; AAP-CA Leadership; Lydia Bourne