Factors that influence scope of practice of the five largest health care professions in Australia: a scoping review.

INTRODUCTION: A well-functioning health system delivers quality services to all people when and where they need them. To help navigate the complex realm of patient care, it is essential that health care professions have a thorough understanding of their scope of practice. However, a lack of uniformity regarding scope of practice across the regulated health professions in Australia currently exists. This has led to ambiguity about what comprises scope of practice in some health care professions in the region. OBJECTIVE: The objective of this review was to explore the literature on the factors that influence scope of practice of the five largest health care professions in Australia. METHODS: This study employed scoping review methodology to document the current state of the literature on factors that influence scope of practice of the five largest health care professions in Australia. The search was conducted using the following databases: AMED (Allied and Complementary Medicine Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Library, EMBASE (Excerpta Medica Database), MANTIS (Manual, Alternative and Natural Therapy Index System), MEDLINE, PubMed, and SCOPUS. Additional data sources were searched from Google and ProQuest. RESULTS: A total of 12 771 publications were identified from the literature search. Twenty-three documents fulfilled the inclusion criteria and were included in the final analysis. Eight factors were identified across three professions (nursing & midwifery, pharmacy and physiotherapy) that influenced scope of practice: education, competency, professional identity, role confusion, legislation and regulatory policies, organisational structures, financial factors, and professional and personal factors. CONCLUSION: The results of this study will inform a range of stakeholders including the private and public arms of the healthcare system, educators, employers, funding bodies, policymakers and practitioners about the factors that influence scope of practice of health professions in Australia.

Factors that influence the scope of practice of the chiropractic profession in Australia: a thematic analysis.

Scope of practice has been defined as the activities that an individual health care practitioner is allowed to undertake within a specific profession. The chiropractic profession in Australia does not currently have a documented scope of practice. Informed discussions around scope of practice are hampered by a paucity of literature in this area. Acknowledging this void in the literature, we chose to investigate the factors that influence scope of practice of the chiropractic profession. A knowledge of the factors will facilitate discussion on the topic and help the profession to work towards establishing a scope of practice.Aim The aim of this study was to identify the factors that influence scope of practice of chiropractic in Australia from the perspective of 4 stakeholder groups within the profession.Methods This study employed semi-structured, online-interviews. Open-ended questions, guided by a flexible interview protocol, and augmented by supplemental questions, probes and comments, were used to gather data on the research question. Data were analysed using reflexive thematic analysis.Results Six factors that influenced scope of practice of chiropractic were identified in this study: education, evidence (research-derived and practice-based), political influence, community expectations, entrepreneurial business models, and geographical location.Conclusion Knowledge of the factors that influence scope of practice of chiropractic in Australia is important for establishing a scope of practice for the profession. This knowledge is also of value to a range of stakeholders including patients, health care providers (within and outside the profession), professional associations, and policymakers.

Factors that influence scope of practice of the chiropractic profession in Australia: a scoping review.

INTRODUCTION: The World Health Organization describes chiropractic as a health profession that treats the musculoskeletal system and the effects of that system on the function of the nervous system and general health. Notwithstanding such descriptions, scope of practice remains a contentious issue in Australia chiropractic with various authors defining it differently. To date, the peak governing body, the Chiropractic Board of Australia, has focused on title protection rather than defining a scope of practice for the profession. A well-defined scope of practice is important, as it helps to identify what is acceptable in the profession and the role chiropractic has in the broader healthcare system. OBJECTIVE: The objective of this scoping review was to explore the literature on the factors that influence scope of practice of chiropractic in Australia. METHODS: This study employed scoping review methodology to document the current state of the literature on factors that influence scope of practice of the chiropractic profession in Australia. RESULTS: A total of 1270 articles were identified from the literature search. Six studies fulfilled the inclusion criteria and were included in the final analysis. Four factors that influence scope of practice were identified: education, professional identity, patient safety, and organisational structure. CONCLUSION: The results of this study will inform future discussions around establishing a framework for a more comprehensive scope of practice for the chiropractic profession in Australia. Such a framework has the potential to benefit patient safety, professional identity, public perception, education, and regulation of the profession.

The Hypothesis of Biotensegrity and D. D. Palmer's Hypothesis on Tone: A Discussion of Their Alignment.

OBJECTIVE: The purpose of this article is to compare D. D. Palmer's hypothesis of tone with the modern hypothesis of biotensegrity. DISCUSSION: Although researchers have been using the hypothesis of biotensegrity for over 40 years to explain the mechanics of movement within biological systems, it has experienced revived support in the last 25 years. Biotensegrity as a concept is applied at the molecular, cellular, tissue, and organ levels, revealing a different understanding of the architecture of biological organisms. Biotensegrity offers a way of exploring the human body in the field of functional anatomy. The model has become popular among bodywork and movement practitioners, as it recognizes the wholeness of the human body. D. D. Palmer used tone to explain the origin of disease; biotensegrity, instead, explains why certain diseases may develop. CONCLUSION: The concept of tone hypothesized by D. D. Palmer is different from the modern concept of biotensegrity. Although biotensegrity offers a different way of seeing how the human body functions, using it as a theoretical framework to explain the effects of manual therapies such as chiropractic may be premature. The use of the biotensegrity hypothesis requires further research and investigation before application in clinical settings.