Changing scopes of practice across health professions
The scopes of practice of health professionals, including physicians, are evolving to bring new levels of competency and latitude in the diagnosis and treatment of patients. For example, the College of Family Physicians of Canada recognizes Certificates of Added Competence in seven domains of care, such as Addictions, Emergency Medicine, Care of the Elderly and Palliative Care 2. Similarly, through its Area of Focused Competence diploma programs, the Royal College recognizes domains of specialized care in areas such as Transfusion Medicine, Hyperbaric Medicine, and Solid Organ Transplantation 3. Registered Nurses in Manitoba can independently order diagnostic tests and prescribe medications for select patients 4. Pharmacists are now able to prescribe medications, administer drugs by injection and order and interpret laboratory tests in select provinces 5. Nurse practitioners in British Columbia are authorized to prescribe drugs used to treat opioid addiction 6. Alberta allows paramedics to administer a broader array of diagnostic tests such as portable laboratory blood testing and ultrasounds 7. At a national level, physicians, nurses and pharmacists are involved in the provision of medical assistance in dying (MAiD) 8.
The Statement on Scopes of Practice calls on regulators and governments to respect a set of principles to manage evolving scopes of practice for all health professionals. The statement outlines a number of key principles. For example, it encourages robust consultation and collaboration with patients and health care providers as scopes of practice are reshaped. It also proposes that the practitioners scope of practice be firmly rooted in their foundational training and education, augmented throughout ones careers through continuing professional development. This is essential to maintain patient safety and wellness during the uptake of new or redesigned scopes of practice of health providers
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