Scope of Practice Laws in Health Care: Exploring New Approaches for California

Sharon Christian and Catherine Dower of the UCSF Center for the Health Professions

These publications highlight models for reviewing and modifying state medical scope-of-practice laws, as well as the feasibility of addressing the shortage of health workers in California by drawing upon former military personnel.

March 2008

Scope of practice laws establish the legal framework that controls the delivery of medical services. The reach of these laws encompasses the full range of disciplines — ranging from physicians and physical therapists to podiatrists and dental hygienists — and governs which services each is allowed to provide and the settings in which they may do so.

With few exceptions, scope of practice statutes are set by state governments. Due to the individualized nature of this process, such laws and regulations vary widely from state to state. Some states allow individual professions broad latitude in the services they may provide, while others employ strict limits. The nature of the limitations can either facilitate or hinder patients’ ability to see a particular type of provider, which in turn influences health care costs, access, and quality.

Funded by a grant from the California HealthCare Foundation, the Center for the Health Professions at the University of California, San Francisco, identified a number of models for reviewing and modifying scope-of-practice laws, and compiled their findings in a detailed report. This CHCF issue brief summarizes those findings, comparing review programs and statutes across the United States and Canada. It also compares California's laws for four professions to those of other state and federal programs that offer broader, more expansive practice provisions.

A second analysis from the Center for the Health Professions examines whether the shortage of health workers in California might be addressed by drawing upon a new labor pool: former military personnel returning from active duty or retiring with years available for service in the civilian labor force.

The report compares a select set of US military health occupations with similar health occupations in California. It finds that while these individuals have received significant health care training in the military, the range of duties can vary, and their job training and job titles may not translate easily into civilian positions.

The scope-of-practice issue brief is available as a Document Download. The two Center for the Health Professions reports are available as External Links.