Regulatory and medico-legal barriers to interprofessional practice.

Unlike the other contributions to this issue, this paper is concerned with the prospects and potential ramifications of implementing interprofessional practice from the legal standpoint. The authors focus on the two forums where the major legal issues are likely to be played out: the laws under which health care professionals are regulated; and the law of professional malpractice as applied by the courts under the tort of negligence. The goal is to examine the regulatory and medico-legal barriers that might prevent or inhibit health care professionals from working together on an interprofessional basis, and to forecast the kinds of changes within legal systems which will be necessary to accommodate the change. The first part of the paper focuses on the legal regimes which govern the Canadian health care system, and argues that the essential integrity of the system of professional self-regulation must be protected in programs of reform that seek to create space for interprofessional practice. The authors also propose a number of specific initiatives of review and legislative change as examples of the role that legal reform can play in the shift to a culture of interprofessional regulation. The second part of the paper focuses on malpractice law and suggests that, while in the long term the superior quality of care brought about by interprofessional practice should produce less liability, in the short term interprofessional practice may fit uneasily within the legal constructs traditionally employed by the courts to evaluate malpractice claims. The authors propose three strategies designed to minimize this risk.