Avoiding Scope-of-Practice Violations

Scope-of-practice violations are among the most common – and costly – regulatory risks for doctors and medical practices. These occur when:

• A provider performs tasks they are not legally permitted or trained to do.
• Tasks are delegated to staff whose licensure does not authorize those activities.

With healthcare teams increasingly relying on multidisciplinary roles, understanding and maintaining scope boundaries is essential for compliance, patient safety, and organizational integrity. Fortunately, you can take practical steps to reduce risk and strengthen oversight.

Know Your Own Scope of Practice
State medical boards define what doctors may and may not do, and these definitions vary widely by jurisdiction. Specialties may have specific limitations or competency expectations, especially in:

• Controlled substances
• Telehealth
• Device-based treatments
• Surgical procedures

Laws and regulations evolve constantly, so as a responsible practitioner, it’s important to pay attention to board updates, professional society guidance, and continuing education resources.

Understand Your Team’s Scope
Many violations occur because tasks are delegated incorrectly. Each role – physician assistant, nurse practitioner, registered nurse, licensed practical nurse, medical assistant, technician – has statutory limits. You should maintain written job descriptions aligned with state laws and avoid assuming staff can perform tasks because they did so elsewhere. Pay special attention to tasks like injections, laser use, wound care, and medication management.

Delegate and Supervise Properly
Provide the legally required level of supervision (direct, indirect, or chart review). Document supervisory activities, especially for:

• New hires
• Complex patients
• Procedures involving controlled substances

Keep standing orders and protocols:

• Written
• Updated regularly
• Accessible to all staff

Implement Strong Internal Policies
Create clear task lists for each role and develop “doctor-approval required” lists for high-risk procedures. Provide structured training on documentation, billing rules, and delegation requirements.

Prioritize Ongoing Training
Conduct annual scope-of-practice training for all staff. Perform competency assessments for procedures. If you’re going to adopt new technologies (lasers, diagnostic devices, AI tools) make sure you provide adequate physician training and documented competency.

Foster a Culture of Communication
Encourage team members to ask questions and report concerns. When in doubt, consult your state medical board, professional societies, local legal counsel, or risk management experts.

Bottom Line
By maintaining awareness, establishing clear policies, and ensuring proper training and supervision, physicians can reduce risk, protect patient safety, and enhance compliance and quality of care.

If you are not currently insured with PICA, take a moment to see how we protect our podiatrists. Fill out our online form to receive a free, no-obligation quote.

Disclaimer: The information contained on the PICA Blog does not establish a standard of care, nor does it constitute legal advice. The information is for general informational purposes only. We encourage all blog visitors to consult with their personal attorneys for legal advice, as specific legal requirements may vary from state to state. Links or references to organizations, websites, or other information is for reference use only and do not constitute the rendering of legal, financial, or other professional advice or recommendations. In the event any of the information presented conflicts with the terms and conditions of any policy of insurance offered by ProAssurance Insurance Company of America, the terms and conditions of the actual policy will apply. All information contained on the blog is subject to change.