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Scope of Practice

The Oregon Legislature has given the Oregon Medical Board the power to exercise general supervision over the practice of medicine and podiatry within the state.  Increasingly health professionals, some licensed by this Board and some by other agencies, are seeking to extend the scope of their practice and authority.

While the ultimate decision on scope of practice issues generally rests with the Legislature, the Board assists lawmakers by providing complete and accurate information upon which to base decisions.  The following factors are considered when the Board reviews scope of practice questions:

  • Public safety must be the primary focus;
  • The patient should receive the same level of care and informed consent regardless of who provides the care;
  • Fully qualified providers must perform procedures, whether those providers are physicians or other health care professionals.  With extensive years of medical training, physicians have broad authority and considerable latitude in the scope of their medical practice.  Health care providers with less formal education need a clearly defined scope of practice in keeping with Oregon statutes.

When considering scope of practice changes for professions or individuals under its own jurisdiction, the Board considers the following:

  • Education:  Has the provider received education from an approved institution with national standards and what is the core education in terms of residency, post-graduate education and continuing education courses?
  • Experience:  What experience has the practitioner had recently relative to the proposed expansion in scope of practice?
  • Level of Supervision:  When health care professionals work under supervision, the Board expects the supervisor to be identified in advance and to be skilled in the procedure he/she is supervising. The supervisor must also assume responsibility for delegation of duties.
  • Back-up Assistance Available:  Before undertaking a scope of practice change, a functional back-up system must be identified in advance, with the availability of review similar to hospital peer review.
  • Demonstration of Skill Level:  In assessing ability, the Board looks for proficiency demonstrated under supervision, documented by an unbiased third party.  There needs to be verified outcomes following an appropriate number of procedures over a given period of time.

Prior to the addition of a diagnostic or therapeutic technique to a health practitioner’s scope of practice under any jurisdiction, the Board believes that the following questions should be answered in addition to the above outlined standards:

  • What is the current standard of practice and is the skill being added appropriate to the professional background?
  • What background is sufficient to prepare the professional to perform a given procedure safely?
  • Does the individual have adequate experience to understand appropriate indications and handling of complications?

The citizens of Oregon expect and deserve the same high quality care for the same medical service rendered irrespective of the background, training, skill and knowledge of the health care provider.  It is on this basis that the Oregon Medical Board carefully reviews questions of expanded scope of practice for health care providers.

-Adopted July 1999