This is the Kator Daily Podcast for Tuesday, February 28th, 2003.

I'm Caleb Brown.

When the state creates licenses for medical professionals in various fields, they're carving up territory.

And then the incumbent practitioners will fight to defend and expand their unique territory.

The results of them fighting have been enormously costly

for patients seeking care. Cato's Jeff Singer provides some of the

historical context of these fights. When we talk about medicine and we talk about receiving health care, what do we, what is

scope of practice and why is it, why does it affect our health care delivery systems so much?

Well scope of practice is a term that refers to what different health care licensed health care practitioners are

permitted to do in that field. Since the late 1800 states began licensing health care professionals.

And when a state gives you permission or a license to practice, let's say, as a dentist, it then defines in a law what dentist may and may not do.

So it would say something like dentist, you know, for example, dentists can't do surgery outside of the oral cavity, those kind of things.

And so it's kind of the licensing then begs the question, okay, so I'm licensed as a nurse practitioner or as a physician.

So what does that mean?

What can I do?

And then in the law, it defines what can be done that's supposed to be enforced by the licensing board that is established

and then of course from time to time different groups can go before the legislature and ask for adjustments to be made in those scopes of practice that have been defined.

So, you know, I'm familiar at least my household rather is very familiar with cases of like a board of dentistry

reaching out to people who do teeth whitening and saying, n nope, nope, no, no, buddy, that's dentistry right there.

And we can argue about whether or not that's

reasonable in general it probably is not especially we could buy the same ingredients

at a store and do it yourself at home but for nurse practitioners, for you know, other kinds of nurses.

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