Welcome to the MEDLRN blog, where we provide valuable insights to help healthcare professionals advance their careers. Today, we’re focusing on a topic that many healthcare professionals struggle with – understanding and defining your scope of practice.
What is a Scope of Practice?
A scope of practice (SOP) is fundamentally an area in which you are competent to advise, manage, and treat patients. Let’s break this down further:
Your scope of practice is a disease state or condition that you can safely:
- Manage
- Diagnose
- Treat
For example, if you’re a community pharmacist, your scope of practice might include acute conditions or minor illnesses. The key is identifying an area where you have the knowledge and experience to provide comprehensive care.
How to Determine Your Competency in an Area
When assessing your competence in a particular area, the Royal Pharmaceutical Society (RPS) framework for prescribers is an excellent resource. This framework provides a set of statements that you must be able to justify.
For instance, one statement might read, “I thoroughly take a history.” You need to ask yourself: In this disease state, can I take a thorough history? Do I know all the differential diagnoses?
To truly understand a condition well enough to include it in your scope of practice, you should know about:
- Incidence: How common is the condition?
- Age: How does age affect the condition?
- Sex: How do biological differences impact the presentation or treatment?
- Geography: Is this condition more common in certain areas?
- Etiology: What causes the condition?
- Pathology: What happens at both microscopic and macroscopic levels?
- Signs and symptoms: What are the clinical presentations?
- Treatment: What are the appropriate interventions?
When considering your scope of practice, ask yourself: “Can I safely manage, diagnose, and treat this disease?” If you’re uncertain, the RPS framework is a good starting point to evaluate your knowledge and skills.
How to Choose Your Scope of Practice
Your scope of practice should align with your professional experience and daily practice. Different healthcare professionals will naturally have different scopes:
- Community pharmacists often see acute conditions like coughs, colds, ear/nose/throat issues, respiratory conditions, and skin conditions
- Nurses or pharmacists in general practice might focus on chronic conditions like asthma, diabetes, or hypertension
- Paramedics will have their own distinct areas of expertise
The key is to choose a scope that reflects your individual experience and what you can safely manage, diagnose, and treat based on your current role and knowledge base.
Example Areas for Your Scope of Practice
When defining your scope of practice, you might consider focusing on specific body systems or condition categories:
ENT Conditions
This could include otitis media, otitis externa, sinusitis, and related conditions.
Respiratory Conditions
While this theoretically includes ENT, you might specifically focus on conditions like asthma, COPD, pneumonia, bronchitis, and other lung infections.
Abdominal Conditions
These would include various digestive and gastrointestinal issues.
Skin Conditions
From common infections to inflammatory conditions of the skin.
Musculoskeletal Conditions
Including joint, muscle, and bone-related issues.
These broad areas provide a starting point, but you’ll need to define your specific scope based on your personal experience and competence.
How to Write Your Scope of Practice
This is what most healthcare professionals are most curious about – the practical aspect of documenting your scope of practice. It’s important to note that university requirements vary:
- Some universities expect a very narrow scope of practice
- Others prefer a broader scope
Broad Scope of Practice Example
A broadly defined scope might read:
“I will diagnose, manage, and treat ENT-related conditions and their differentials in children and adults aged six years and older, with no comorbidities and otherwise well.”
This statement includes:
- The body system (ENT)
- The age range (6+ years)
- Inclusion of both males and females
- Mention of differential diagnoses
- Exclusion criteria (no comorbidities)
Narrow Scope of Practice Example
A more narrowly defined scope might read:
“I will diagnose, manage, and treat bacterial pharyngitis in children aged six to 18 years with no comorbidities.”
This approach focuses on:
- A specific condition (bacterial pharyngitis)
- A narrower age range (6-18 years)
- Specific exclusion criteria (no comorbidities)
It’s crucial to check with your specific university about their requirements. For example, Leicester University typically requires a broader scope of practice, while others may prefer a more narrowly focused one.
The Essential Requirement: Demonstrable Competence
Regardless of whether you choose a broad or narrow definition, the most important aspect of your scope of practice is that you can demonstrate competence within it. It’s not sufficient to have just a superficial understanding of the disease state – you need comprehensive knowledge as outlined earlier.
Ask yourself: “Do I safely manage, diagnose, and treat these conditions in my current practice?” If the answer is no, then that area should not be included in your scope of practice.
Summarizing How to Write Your Scope of Practice
When documenting your scope of practice, follow this basic formula:
“Diagnosis, management, and treatment of [insert disease state or body system] in [age range] with [any specific inclusionary or exclusionary criteria].”
For example:
- “Diagnosis, management, and treatment of ENT-related conditions in adults and children aged six years and older with no comorbidities.”
- “Diagnosis, management, and treatment of type 2 diabetes in adults aged 18 and older with no complex comorbidities.”
Conclusion
Understanding your scope of practice is essential for healthcare professionals pursuing prescribing qualifications. It defines the boundaries within which you can safely practice and forms a fundamental part of your development as a prescriber.
Remember that your scope of practice should:
- Reflect your actual experience and competence
- Cover conditions you can safely manage, diagnose, and treat
- Be appropriately detailed according to your university’s requirements
- Demonstrate your comprehensive understanding of the included conditions
For more information on pursuing prescribing qualifications, including how to find a Designated Medical Practitioner (DMP) or Designated Prescribing Practitioner (DPP), visit our website at www.medlrn.com.
Together, let’s build a better healthcare system by ensuring all practitioners have a clear and appropriate scope of practice that enables safe and effective patient care.
