It’s a pesky phrase that has the potential to inspire both confusion and frustration: “Working at the top of scope”.

Where have you heard this before?

It generally comes up when shortages in the medical workforce lead to calls for other healthcare professionals to “step up”.

What, though, is each profession’s scope, and how do we know when we are working within scope, let alone at the “top”?

In medicine, “scope of practice” is broadly understood, due to training and the roles of the various specialties, whether in the hospital or the community.

This is further clarified by standards developed by the specialty colleges and associations, health departments and institutions.

Although there is inevitably a large amount of overlap in scope between medical providers, there is better definition and credentialing for procedural skills.

Scope of practice is less well defined between healthcare professions.