A gap has developed within the United States health care industry between the abilities of non-physician care providers and the activities government regulation allows them to perform. Dominant provider groups extensively lobby state legislators in order to obtain scope-of-practice monopolies, which confer exclusive control over their areas of interest and exclude other equally-capable groups from performing such services. As a result, the excluded providers' skills are under-used, creating a systemic inefficiency. This Essay explores the development of the current scope-of practice system and discusses possible solutions, including a review of current reforms in Colorado and Ontario, Canada.

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