Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association

Scope of practice regulation in medicine: balancing patient safety, access to care and professional autonomy

Christian A. Gericke A B C *
+ Author Affiliations
- Author Affiliations

A School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.

B Calvary Mater Newcastle, Waratah, NSW, Australia.

C School of Public Health, University of Queensland, Herston, Qld, Australia.

Australian Health Review 48(1) 1-3
Submitted: 17 January 2024  Accepted: 18 January 2024  Published: 1 February 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.


Scope of practice regulation in medicine is crucial for ensuring patient safety, access to care and professional autonomy. This paper explores the impact of scope of practice regulation on healthcare delivery, professional responsibilities and patient outcomes. It discusses the variability in standards for safe practice, the challenges in defining boundaries between medical specialties and the recent controversies in cosmetic surgery practice. The paper also examines the potential benefits and drawbacks of rigorous scope of practice regulations, including their impact on clinical innovation, flexibility and access to care. Furthermore, it delves into the implications of defensive medicine and the consequences of restrictive regulations on patient care. The author proposes implementing a proactive, national, artificial intelligence-powered, real-time outcome monitoring system to address these challenges. This system aims to cover every patient undergoing a surgical procedure and could be gradually extended to non-surgical conditions, benefiting all key stakeholders in the health system. The paper emphasises the need for a balanced approach to scope of practice regulation to avoid stifling clinical innovation and professional autonomy, while ensuring patient safety and professional accountability.

Keywords: health law, health policy, hospitals, litigation, medical negligence, performance and evaluation, professional autonomy, quality and safety.


Davison SP, Hancock M, Sinkiat M, Enchill Z. Oral Surgeons as Cosmetic Surgeons and Their Scope of Practice. Plast Reconst Surg 2019; 143(4): 872-9.
| Crossref | Google Scholar | PubMed |

ABC. Videos show ‘dangerous’ practices in Daniel Lanzer’s cosmetic surgery clinics, plastic surgeons say. Australian Broadcasting Corporation; 2021. Available at [cited 17 January 2024].

AHPRA. Endorsement of registered medical practitioner registration for the approved area of cosmetic surgery. Medical Board of Australia/Australian Health Practitioner Regulatory Agency; 2023. Available at

Health Practitioner Regulation National Law (Surgeons) Amendment Act 2023. Queensland Government; 2023, Available at

Arias JJ. Becoming the Standard: How Innovative Procedures Benefitting Public Health Are Incorporated Into the Standard of Care. J Law Med Ethics 2011; 39: 102-5.
| Crossref | Google Scholar | PubMed |

Holm S, Stanton C, Bartlett B. A New Argument for No-Fault Compensation in Health Care: The Introduction of Artificial Intelligence Systems. Health Care Anal 2021; 29: 171-88.
| Crossref | Google Scholar | PubMed |

Walsh J, Downie S, Windholz E, Kirk-Brown A, Haines TP. Clinical innovation and scope of practice regulation: a case study of the Charlie Teo decision. Aust Health Rev 2023; 48: 91-94.
| Crossref | Google Scholar | PubMed |

Brajer N, Cozzi B, Gao M, Nichols M, Revoir M, Balu S, Futoma J, Bae J, Setji N, Hernandez A, Sendak M. Prospective and External Evaluation of a Machine Learning Model to Predict In-Hospital Mortality of Adults at Time of Admission. JAMA Netw Open 2020; 3(2): e1920733.
| Crossref | Google Scholar |

Gu D, Zhang X, Diao X, Zhao W, Zheng Z. Surgeon-Specific Quality Monitoring System for Coronary Artery Bypass Grafting. Ann Thorac Surg 2019; 107(3): 705-10.
| Crossref | Google Scholar | PubMed |

10  Ramakrishnaiah Y, Macesic N, Webb GI, Peleg AY, Tyagi S. EHR-QC: A streamlined pipeline for automated electronic health records standardisation and preprocessing to predict clinical outcomes. J Biomed Inform 2023; 147: 104509.
| Crossref | Google Scholar | PubMed |

11  Busse R, Nimptsch U, Mansky T. Measuring, monitoring, and managing quality in Germany’s hospitals. Health Aff 2009; 28(2): w294-304.
| Crossref | Google Scholar | PubMed |

12  Doctors' Association UK. Learn Not Blame. Doctors' Association UK; 2024. Available at [cited 14 January 2024].