A practitioner’s scope of practice is highly individualised. Consequently, it can be difficult for some to determine where the edges of their scope lie. Dr Annalene Weston, dentolegal advisor, critically appraises scope of practice in the contemporary landscape.

On 1 July 2010, the Australian Health Practitioner Regulation Agency (AHPRA) heralded a new beginning, brushing aside the old and rolling out the new. Rapidly. Eight years on, as the dust begins to settle, it is a good time to take stock and evaluate what the contemporary post-AHPRA landscape looks like for a dental practitioner.

It will not come as news to any dental practitioner that scope of practice is the current go-to position in any regulatory investigation. Crystallised in 2014 through a series of documents¹, scope of practice remains difficult to define and, at times, can be difficult to defend.

However, as time progresses and Dental Protection continue to actively defend and, through this defence, shape the profession’s understanding and interpretation of scope of practice, we are well placed through our experiences to share some broad advice.
1) Stop, and think about it.

The first question you should ask yourself when approaching a new treatment is: “Am I really practising dentistry?” As the boundaries between treatment modalities, the roles of individual health providers and cosmetic wishes versus functional needs continue to blur, it can be surprising to some to realise where dental practitioners may end up. If, however, you ask yourself this question, you are not really sure, or you find yourself having to justify this particular element of your dentistry more than your core practice, stop – and seek advice.

2) Prove it!

The onus to validate that you are working within your scope of practice lies with you. Not your employer. Not the person(s) who have taught you the new technique. Not peers who are already providing that type of practice (and whose scope may significantly differ from yours). It’s all on you.

You will be required by your regulator to validate your training, competency, education and, of course, that you are actively undertaking relevant and appropriate continuing profession development.
In the recent past, many dental practitioners have not met the requirement of 60 hours of CPD during the relevant three-year cycle. If you are being investigated by the Board, the failure to meet this requirement of your registration will only serve to be another nail in the coffin of your professional reputation.

3) Be true to you

Peer pressure should have ended with high school, but it didn’t. I have great sympathy for those who have been ridiculed or cajoled by their peers for ‘falling behind’, or even compelled by their employer to breach their scope. But remember, the person left to face the consequences of a breach of scope will be you: many of these highly vocal advocates will fade into the distance when the axe falls.

4) Is there hope for scope?

The most recent Dental Board communique² confirms that the Board will shortly commence a public consultation regarding a proposed “Revised scope of practice registration standard” and accompanying guidelines. Their direction of travel remains uncharted, but it can be surmised that the Board too has found scope of practice to be vexing and is looking to modify and improve. Time will tell what the outcome of this will be.

References:

1. Dental Scope of practice registration standard
   Dental Guidelines – scope of practice registration standard
   FAQ – Scope of practice registration standard
2. http://www.dentalboard.gov.au/News/Communiques.aspx