A comparison of the regulation of health professional boundaries across OECD countries

Increased attention has been paid recently to the issue of the regulation of professional boundaries. In this paper, we undertake an international comparison of the regulation of health professional boundaries across the OECD countries of Canada, the U.S., the U.K. and Australia. Our case studies fo...

Full description

Saved in:
Bibliographic Details
Published in:The European journal of comparative economics : EJCE 2013-08, Vol.10 (2), p.199-223
Main Authors: Bourgeault, Ivy Lynn, Grignon, Michel
Format: Article
Language:English
Subjects:
Arbeitserlaubnis
Arbeitsmigration
Arzt
Ausländer
Australia
Australien
Berufliche Integration
Berufsrecht
Canada
Case studies
Collaboration
Comparative analysis
Comparative economics
Comparative studies
Doctors
Einwanderer
Family physicians
Gesundheitsberuf
Großbritannien
Health care industry
health professional regulation
Institution
inter-professional care
International comparisons
international medical graduates
Internationaler Vergleich
Interprofessional cooperation
Jurisdiction
Kanada
Krankenschwester
Kultur
Laws, regulations and rules
Lizenz
Medical personnel
Migration
Nurses
Nursing
OECD
Permeability
Physicians
Politics
Practice
Professional development
Professional ethics
Professionals
Professions
Regulation
Regulatory compliance
Skills
Social exclusion
Social responsibility
the U.K
the U.S
U.S.A
United Kingdom
USA
Western Europe
Ökonomische Determinanten
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Increased attention has been paid recently to the issue of the regulation of professional boundaries. In this paper, we undertake an international comparison of the regulation of health professional boundaries across the OECD countries of Canada, the U.S., the U.K. and Australia. Our case studies focus on the inter-professional boundary negotiation between medicine and nursing and the intraprofessional boundary negotiation between domestic and internationally trained physicians. Our analysis draws upon the complementary interdisciplinary theoretical perspectives of institutional economics and the concept of professional closure from the sociology of professions. In applying these lenses to the two case studies in these four country contexts, we reveal that there has been a shift in the context of professional regulation towards a more coordinated national approach to licensure. There has also been a broad scale move towards breaking down at least the regulatory barriers to inter-professional collaboration between physicians and nurses which has included the expansion of the scope of nursing practice to take up traditionally exclusive domains of medicine. The seemingly protectionist professional regulatory policies vis-a-vis international medical graduates also seem to be breaking down primarily through government measures. Overall, there has been an increased permeability of professional boundaries both interprofessionally and intra-professionally, and market-oriented systems seem to be in a better position to overcome medical dominance than state-led ones, even though they do not change the main rules of regulation at the macro-level.
ISSN:1824-2979
1824-2979