The impending doc shortage has spurred a lot of discussion about whether scope-of-practice laws ought to be relaxed to allow nurse practitioners and other medical professionals to assume greater responsibilities for primary care. This is, of course, just the latest iteration of a never-ending legal debate over the proper role of the state in regulating the practice of medicine—a debate that stretches back to at least 1512 and the reign of King Henry VIII:
Where in the Parliament holden at Westminster in the third year of the King’s most gracious reign, amongst other things, for the avoiding of sorceries witchcrafts and other inconveniences, it was enacted, that no person within the city of London, nor within seven miles of the same, should take upon him to exercise and occupy as physician or surgeon, except he be first examined approved and admitted by the Bishop of London and other, under and upon certain pains and penalties in the same act mentioned;
[S]ithence the making of which said act, the Company and Fellowship of Surgeons of London, minding only their own lucres, and nothing the profit or ease of the diseased or patient, have sued troubled and vexed divers honest persons, as well men as women, whom God hath endued with the knowledge of the nature kind and operation of certain herbs roots and waters, and the using and ministring of them to such as been pained with customable diseases, … and yet the said persons have not taken any thing for their pains or cunning, but have ministred the same to poor people only for neighborhood and God’s sake, and of pity and charity.
And it is now well known, that the surgeons admitted will do no cure to any person, but where they shall know to be rewarded with a greater sum or reward than the cure extendeth unto; … for although the most part of the persons of the said craft of surgeons have small cunning, yet they will take great sums of money and do little therefore, and by reason thereof they do oftentimes impair and hurt their patients, rather than do them good:
In consideration whereof, … be it ordained established and enacted, by authority of this present Parliament, That at all time from henceforth it shall be lawful to every person being the King’s subject, having knowledge and experience of the nature of herbs roots and waters, or of the operation of the same, by or within any other the King’s dominions, to practice use and minister in and to any outward sore uncome wound apostemations outward swelling or disease, any herb or herbs, ointments baths pultess and emplaisters, according to their cunning experience and knowledge in any of the diseases sores and maladies beforesaid, and all other like to the same, or drinks for the stone strangury or agues, without suit vexation trouble penalty or loss of their goods; …