Australian Health Practitioner Regulation Agency: Telemedicine Guide for Practitioners. 2020. www.ahpra.gov.au/News/COVID-19/Workforce-resources/Telehealth-guidance-for-practitioners.aspx. Retrieved 25 November 2020. Responses considered as signs of disagreement or compliance with the legal framework, or when the participant was unsure or the answer was unclear, represented by the scenario. Baranek, Prime Minister. «Review of Health Professions Activities in Canada: A Balancing Exercise,» report for the Health Council of Canada: 2005. healthcouncilcanada.ca/133/. Retrieved 25 June 2020. Australia has undergone a major change in the legal framework and institutions that govern the regulation of health practitioners. Historically, health professions have been regulated by law according to models that were primarily profession-specific, based on both restrictive practices and titles.
As a result, areas of practice were restricted or protected by law and had relatively little response to the changing needs of the population and to the design of the health system and workforce. The legislation and institutions that regulate naturopaths have not only been separated by profession, but have also been replicated for each of the eight jurisdictions in the federation. It was a highly fragmented and dual system for a country relatively large by land mass, but with a small and dispersed population. Despite mutual recognition mechanisms, this model presented barriers to mobility, different professional standards and regulatory costs for cross-border practice. Another Canadian province, Nova Scotia, has adopted an alternative approach to facilitate regulatory collaboration and flexible areas of application. In 2012, Nova Scotia passed the Regulated Health Professions Network Act  to establish a statutory network of self-regulated health professionals that allows for voluntary regulatory collaboration. Network legislation empowers regulatory bodies to enter into agreements on the interpretation or modification of practice areas without the need for further legislative amendments, provided that the provincial Minister of Health determines that the agreement is in the public interest . Reform is currently being proposed in British Columbia to reduce the number of regulators from 20 to six ; This reform recognizes that the isolated regulation of individual professions does not allow regulatory colleges to respond flexibly to the complexities of modern team-based care. Bourgeault II, Grignon M. A comparison of the regulation of health professions boundaries in OECD countries.
Eur J Comp Econ. 2013a;10(2):199-223. The pandemic has also revealed a fundamental truth: society is changing rapidly, while regulation and law tend to be more static and regulatory frameworks need to be more flexible and responsive to meet the needs of modern society . This also applies to the regulation of practice areas, as modern team-based care and technological advances are increasingly changing the way health professionals work. Despite the link between regulatory modernization and health workforce optimization, there is a lack of knowledge about the impact of different regulatory models on the areas of practice of health professionals. Half of the participants (46%, 58/127) provided responses that were not in agreement with the legal framework in all five scenarios. Only two participants (2%) provided consistent responses in all five scenarios, both had nursing training and were actively involved in research that included recruiting participants for trials. Twenty-four participants gave «don`t know» or uncertain answers to one or more scenarios, including one participant who responded that he was not sure in all five vignettes. Sticker 3, which included a low-risk study with a communication device tested in a nursing home, had the highest number of dangerous responses (9%, 12/127). Most participants were experienced professionals who had been in their position for >8 years (83%), and many were involved in research in a variety of research roles (63%), but most often they recruited participants (55%, 44/80).
Leslie, K., Moore, J., Robertson, C., Bilton, D., Hirschkorn, K., Langelier, M. H., and Bourgeault, I. L. (2021). Regulation of Health Professional Practice Areas: A Comparison of Institutional Agreements and Approaches in the United States, Canada, Australia and the United Kingdom. Human Resources for Health, 19(15). doi.org/10.1186/s12960-020-00550-3 The COVID-19 pandemic has highlighted the need to optimize the workforce by ensuring that all professionals can fully practise , and there have also been calls for the scope of practice not to be unnecessarily restricted during the pandemic . Maintaining public protection while ensuring access to needed health workers has become increasingly important during the pandemic. A joint statement from U.S.
health care regulators describes their «shared duty» during COVID-19 to do everything possible to ensure access to health care across the country . Lippert  adds that part of the regulatory mandate must be to ensure the most efficient and effective means of getting health care providers to where they are needed. Although beyond the scope of this document, the impact of changes in scope of activity on the physical and mental health and safety of health workers should be considered in future work. In many countries, pandemic response plans have not explicitly considered these critical considerations , and post-pandemic reversals in scope of practice extensions can negatively impact the well-being of health professionals . The traditional model of health professional regulation in Canadian provinces is based on separate legislation and exclusive areas of practice for each profession. There is a trend away from this model towards roof framing, which is characterized by overlapping areas of practice [38, 39, 43,44,45,46,47,48,49,50,51,52,53]. It began with the Regulated Health Professions Act, 1991 (RHPA)  in Ontario and other provinces, which have since followed with similar umbrella legislation. The privacy rule generally allows, but does not require, insured health care providers to allow patients to choose whether their health information can be shared with others for certain important purposes. These main goals include treatment, payment, and health care. Participants chose the answer for the legally authorized decision-maker, represented by scenario. Participants were able to select more than one answer from all tiles.