Non-physician health care practitioners are increasingly being used to render services in rural and underserved areas to make up for provider shortages. A practitioner’s scope of practice refers to what a health professional can and cannot do to or for a patient, and is defined by state professional regulatory boards—typically with the guidance or instruction of the state’s legislature.
State legislators and other state health policymakers consider a broad range of issues related to scope of practice, including supervision requirements, prescriptive authority and other requirements for practice. These issues are highlighted on this website, with information from the states, D.C. and territories about current legislation affecting scope of practice.
Find more information below on the practitioners featured on this site.
Behavioral health providers assist people with a variety of mental health and substance use needs, in settings from prevention programs to community-based and inpatient treatment programs. Behavioral health providers can also work with primary care teams to facilitate healthy behaviors, address behaviors associated with health risk and improve pain management by focusing on non-drug coping strategies.
The University of Michigan’s Behavioral Health Workforce Research Center provides a comprehensive report on scopes of practice for 10 behavioral health providers. In addition to the report, the center has developed an interactive map of scopes of practice for behavioral health providers across states.
According to the American Association of Nurse Practitioners, nurse practitioners have provided primary, acute and specialty health care to patients of all ages for the past 50 years. As of August 2020, there are more than 290,000 licensed nurse practitioners in the U.S. Nurse practitioners assess patients, order and interpret diagnostic tests, make diagnoses, initiate and manage treatment plans—including prescribing medications. Nurse practitioners blend clinical experience in diagnosing and treating health conditions with an added emphasis on health promotion, disease prevention and health management.
Dental hygienists are oral health providers working together with a dentist to provide preventive and routine care. Since each state has its own specific regulations regarding the responsibilities of dental hygienists, the range of services performed varies from state to state. As of May 2018, the Bureau of Labor Statistics reports approximately 215,000 dental hygienists working in the U.S.
Dental therapists are primary care oral health professionals able to conduct assessments and provide preventive, restorative and limited surgical care. The precise role varies and depends on the therapist’s education and the various state dental regulations and guidelines. There is a growing professional association for dental therapists, the American Academy of Dental Therapy. There are currently few reliable estimates of the number of professionals serving in this capacity.
Dental hygienists and dental therapists practice in private settings, community-based clinics and rural areas. They all practice under varying levels of supervision by dentists, allowing these providers to meet needs in nontraditional, tribal, school-based and community settings.
Pharmacists must have advanced education and hold a doctor of pharmacy degree. They must also be licensed, which requires passing the North American Pharmacist Licensure Exam (NAPLEX) and, in most states, the Multistate Pharmacy Jurisprudence Exam (MPJE). Pharmacists who administer vaccinations and immunizations must also be certified in most states. As of May 2019, there are more than 311,000 licensed pharmacists working in the U.S.
Pharmacists may enter into collaborative practice agreements with other health care providers, such as physicians and nurse practitioners. These collaborations can increase care coordination and access to more services and providers. For example, providers can delegate tasks to pharmacists such as chronic care management and medication refill authorization. Allowing pharmacists to prescribe certain medications is a growing trend among states seeking to increase access to important medications.
According to the American Academy of Physician Assistants, physician assistants diagnose illnesses, develop and manage treatment plans and prescribe medications, among other things. As of October 2020, there were more than 140,000 physician assistants practicing in the U.S., working in all areas of medicine. In rural and underserved areas, physician assistants may be the only primary care providers at clinics where a physician is present only a few days a week. Physician assistants collaborate with physicians and other health care providers in a team environment.