Factors That Can Facilitate and Inhibit Process of Change
| Facilitator | Barrier |
| Laws or regulations that enable change | Laws or regulations that restrict advancement of a role or change in responsibilities |
| Guidelines for practice that enable change | Fear of litigation |
| Presence of key players who support the desired change | Presence of trainee doctors who want roles that allow them to develop |
| Shortage of nuclear medicine physicians | Fear of change |
| Technologic advancement | Fear of losing money in cases of fee for service |
| Financial pressure in the health care sector | Fear of losing turf |
| Effective use of the potential skills and capabilities of all professionals | Fear of losing power and status |
| Role models who already do advanced practices | Conflict about roles |
| Inability to support suitable advanced practice education and training | |
| Fear of accepting new responsibilities |