Modernizing Scope-of-Practice Regulations — Time to Prioritize Patients

Product type: article published in New England Journal of Medicine (NEJM) on February 13th, 2020.

Authors: Bianca K. Frogner, Ph.D., Erin P. Fraher, Ph.D., M.P.P., Joanne Spetz, Ph.D., Patricia Pittman, Ph.D., Jean Moore, Dr.P.H., Angela J. Beck, Ph.D., M.P.H., David Armstrong, Ph.D., and Peter I. Buerhaus, Ph.D., R.N.

Overview: Erin Fraher, PhD, MPP, Bianca Frogner PhD and the directors of several other publicly and privately funded workforce researcher centers published a perspective article on scope-of-practice (SOP) regulations in the most recent issue of New England Journal of Medicine. Fraher is the director of federally funded Carolina Health Workforce Research CenterModernizing Scope-Of-Practice Regulations details the current state of national and state SOP laws and how they have failed to keep pace with health care transformation and may be, instead, hindering health care organizations from innovating care delivery.

In the U.S., state legislators define legal scopes of practice for health professionals. Not only do these laws vary state to state, they are also not always evidence-based. In a system that IS increasingly moving toward value, health systems and policy makers are increasingly recognizing these laws can hinder innovation, unnecessarily restrict access to care, and raise costs without improving the quality of patient care.  Unfortunately, state laws and organizational policies are often informed by professional lobbying rather than patient interests.  “Patients, not health professions, should be at the center of the conversation on scope of practice,” says Fraher. “We should be asking, ‘what are the population’s health care needs?’ and then planning our workforce and workflows around those need.”