Health Serv Rep

A significant constraint on new categories of health manpower is the absence of statutory legitimation of their roles. Licensure has been evolved as an effort to assure high-quality health care, but recently it has been a barrier to effective and innovative use of manpower. Medical and Nurse Practice Acts generally define the practices of medicine and nursing, but they do not define clearly the scope of these practices. Thus, these acts subject physicians to undue risks in delegating responsibilities and Type A assistants (nurses or non-nurses with special training) to undue risks in accepting those functions. Furthermore, only vague guidelines are provided to protect the public and to assure adequate quality control. To date, 35 States have enacted legislation to provide statutory legitimation of Type A assisants and to permit physicians to delegate appropriate responsibilities to new types of health manpower. It is hoped that this legislation will diminish barriers to effective use of health manpower.

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Public Health Reports